National Provider Identifier [NPI]: |
1760641666 |
Last Name Of The Provider |
GYAMBIBI |
First Name Of The Provider |
KAKRA |
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 |
20 YORK STREET, CB-2041 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW HAVEN |
Zip Code Of The Provider |
06510 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
757 |
Number Of Medicare Beneficiaries |
347 |
Total Submitted Charge Amount |
215200.3 |
Total Medicare Allowed Amount |
81724.82 |
Total Medicare Payment Amount |
62371.96 |
Total Medicare Standardized Payment Amount |
58871.75 |
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 |
16 |
Number Of Medical Services |
757 |
Number Of Medicare Beneficiaries With Medical Services |
347 |
Total Medical Submitted Charge Amount |
215200.3 |
Total Medical Medicare Allowed Amount |
81724.82 |
Total Medical Medicare Payment Amount |
62371.96 |
Total Medical Medicare Standardized Payment Amount |
58871.75 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
116 |
Number Of Female Beneficiaries |
193 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
252 |
Number Of Black or African American Beneficiaries |
53 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
209 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
37 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
50 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.3867 |