| National Provider Identifier [NPI]: | 1790063014 |
| Last Name Of The Provider | GHOSH |
| First Name Of The Provider | ANIRBAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3219 CENTRAL AVE |
| Street Address 2 Of The Provider | SUITE#200 |
| City Of The Provider | KEARNEY |
| Zip Code Of The Provider | 688472949 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 1804 |
| Number Of Medicare Beneficiaries | 59 |
| Total Submitted Charge Amount | 37076 |
| Total Medicare Allowed Amount | 19652.76 |
| Total Medicare Payment Amount | 16039.06 |
| Total Medicare Standardized Payment Amount | 16643.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1397 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 9453 |
| Total Drug Medicare AllowedAmount | 6193.18 |
| Total Drug Medicare PaymentAmount | 4971.57 |
| Total Drug Medicare Standardized Payment Amount | 4971.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 407 |
| Number Of Medicare Beneficiaries With Medical Services | 59 |
| Total Medical Submitted Charge Amount | 27623 |
| Total Medical Medicare Allowed Amount | 13459.58 |
| Total Medical Medicare Payment Amount | 11067.49 |
| Total Medical Medicare Standardized Payment Amount | 11672.06 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 20 |
| Number Of Beneficiaries Age 75 to 84 | 18 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 24 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2942 |