National Provider Identifier [NPI]: |
1801074455 |
Last Name Of The Provider |
GUPTA |
First Name Of The Provider |
BHAVNA |
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 |
9238 KENNEDY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTH BERGEN |
Zip Code Of The Provider |
070475312 |
State Code Of The Provider |
NJ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
59 |
Number Of Services |
56250 |
Number Of Medicare Beneficiaries |
322 |
Total Submitted Charge Amount |
2459703.51 |
Total Medicare Allowed Amount |
769387.38 |
Total Medicare Payment Amount |
602315.87 |
Total Medicare Standardized Payment Amount |
550044.31 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
34 |
Number Of Drug Services |
51566 |
Number Of Medicare Beneficiaries With Drug Services |
85 |
Total Drug Submitted ChargeAmount |
1422058.51 |
Total Drug Medicare AllowedAmount |
445061.58 |
Total Drug Medicare PaymentAmount |
348776.98 |
Total Drug Medicare Standardized Payment Amount |
348776.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
4684 |
Number Of Medicare Beneficiaries With Medical Services |
322 |
Total Medical Submitted Charge Amount |
1037645 |
Total Medical Medicare Allowed Amount |
324325.8 |
Total Medical Medicare Payment Amount |
253538.89 |
Total Medical Medicare Standardized Payment Amount |
201267.33 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
110 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
199 |
Number Of Male Beneficiaries |
123 |
Number Of Non Hispanic White Beneficiaries |
63 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
226 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
133 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
189 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
26 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
66 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.1907 |