National Provider Identifier [NPI]: |
1740288984 |
Last Name Of The Provider |
GARG |
First Name Of The Provider |
MANISHA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
23874 KEAN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DEARBORN |
Zip Code Of The Provider |
481241804 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
703 |
Number Of Medicare Beneficiaries |
270 |
Total Submitted Charge Amount |
60772.5 |
Total Medicare Allowed Amount |
51090.79 |
Total Medicare Payment Amount |
35003.7 |
Total Medicare Standardized Payment Amount |
34139.18 |
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 |
23 |
Number Of Medical Services |
703 |
Number Of Medicare Beneficiaries With Medical Services |
270 |
Total Medical Submitted Charge Amount |
60772.5 |
Total Medical Medicare Allowed Amount |
51090.79 |
Total Medical Medicare Payment Amount |
35003.7 |
Total Medical Medicare Standardized Payment Amount |
34139.18 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
42 |
Number Of Beneficiaries Age 65 to 74 |
90 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
190 |
Number Of Male Beneficiaries |
80 |
Number Of Non Hispanic White Beneficiaries |
230 |
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 |
231 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2464 |