| National Provider Identifier [NPI]: | 1104854926 |
| Last Name Of The Provider | GHOSH |
| First Name Of The Provider | KIRAT |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13350 TI BLVD |
| Street Address 2 Of The Provider | M/S 327 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752431512 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 248 |
| Number Of Medicare Beneficiaries | 79 |
| Total Submitted Charge Amount | 19293 |
| Total Medicare Allowed Amount | 11721.05 |
| Total Medicare Payment Amount | 7245.68 |
| Total Medicare Standardized Payment Amount | 7710.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1444.2 |
| Total Drug Medicare AllowedAmount | 1237.11 |
| Total Drug Medicare PaymentAmount | 1206.41 |
| Total Drug Medicare Standardized Payment Amount | 1206.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 206 |
| Number Of Medicare Beneficiaries With Medical Services | 79 |
| Total Medical Submitted Charge Amount | 17848.8 |
| Total Medical Medicare Allowed Amount | 10483.94 |
| Total Medical Medicare Payment Amount | 6039.27 |
| Total Medical Medicare Standardized Payment Amount | 6504.35 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 30 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 61 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 79 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.5311 |