National Provider Identifier [NPI]: |
1033197942 |
Last Name Of The Provider |
KHETARPAL |
First Name Of The Provider |
MINOO |
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 |
1320 N MICHIGAN AVE |
Street Address 2 Of The Provider |
SUITE 4 |
City Of The Provider |
SAGINAW |
Zip Code Of The Provider |
486024751 |
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 |
51 |
Number Of Services |
2563 |
Number Of Medicare Beneficiaries |
436 |
Total Submitted Charge Amount |
288872 |
Total Medicare Allowed Amount |
225278.65 |
Total Medicare Payment Amount |
168486.93 |
Total Medicare Standardized Payment Amount |
174596.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
128 |
Number Of Medicare Beneficiaries With Drug Services |
119 |
Total Drug Submitted ChargeAmount |
3610 |
Total Drug Medicare AllowedAmount |
3078.04 |
Total Drug Medicare PaymentAmount |
3016.27 |
Total Drug Medicare Standardized Payment Amount |
3016.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
47 |
Number Of Medical Services |
2435 |
Number Of Medicare Beneficiaries With Medical Services |
436 |
Total Medical Submitted Charge Amount |
285262 |
Total Medical Medicare Allowed Amount |
222200.61 |
Total Medical Medicare Payment Amount |
165470.66 |
Total Medical Medicare Standardized Payment Amount |
171579.96 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
131 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
301 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
305 |
Number Of Black or African American Beneficiaries |
98 |
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 |
339 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.5043 |