National Provider Identifier [NPI]: |
1396701884 |
Last Name Of The Provider |
GUDWANI |
First Name Of The Provider |
SANGEETA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3 GATES CIR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BUFFALO |
Zip Code Of The Provider |
142091120 |
State Code Of The Provider |
NY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
360 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
41977 |
Total Medicare Allowed Amount |
28799.34 |
Total Medicare Payment Amount |
22552.28 |
Total Medicare Standardized Payment Amount |
21980.78 |
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 |
6 |
Number Of Medical Services |
360 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
41977 |
Total Medical Medicare Allowed Amount |
28799.34 |
Total Medical Medicare Payment Amount |
22552.28 |
Total Medical Medicare Standardized Payment Amount |
21980.78 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
36 |
Number Of Beneficiaries Age 65 to 74 |
38 |
Number Of Beneficiaries Age 75 to 84 |
16 |
Number Of Beneficiaries Age Greater 84 |
14 |
Number Of Female Beneficiaries |
62 |
Number Of Male Beneficiaries |
42 |
Number Of Non Hispanic White Beneficiaries |
37 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
24 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
33 |
Percent Of With Asthma |
23 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
61 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
71 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
3.2084 |