National Provider Identifier [NPI]: |
1154542769 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
ADITI |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3901 RAINBOW BLVD |
Street Address 2 Of The Provider |
MS3002 |
City Of The Provider |
KANSAS CITY |
Zip Code Of The Provider |
661600001 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
1017 |
Number Of Medicare Beneficiaries |
318 |
Total Submitted Charge Amount |
283201 |
Total Medicare Allowed Amount |
102166.21 |
Total Medicare Payment Amount |
78822.33 |
Total Medicare Standardized Payment Amount |
77474.65 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
1017 |
Number Of Medicare Beneficiaries With Medical Services |
318 |
Total Medical Submitted Charge Amount |
283201 |
Total Medical Medicare Allowed Amount |
102166.21 |
Total Medical Medicare Payment Amount |
78822.33 |
Total Medical Medicare Standardized Payment Amount |
77474.65 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
189 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
25 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
147 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
189 |
Number Of Black or African American Beneficiaries |
74 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
218 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
100 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
32 |
Percent Of With Diabetes |
53 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
20 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
5.0036 |