National Provider Identifier [NPI]: |
1386632875 |
Last Name Of The Provider |
KHULLAR |
First Name Of The Provider |
SUBHASH |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
38800 RYAN RD |
Street Address 2 Of The Provider |
STE 102 |
City Of The Provider |
STERLING HEIGHTS |
Zip Code Of The Provider |
483102993 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
667 |
Number Of Medicare Beneficiaries |
63 |
Total Submitted Charge Amount |
130290 |
Total Medicare Allowed Amount |
87049.27 |
Total Medicare Payment Amount |
62787.17 |
Total Medicare Standardized Payment Amount |
63807.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
440 |
Total Drug Medicare AllowedAmount |
232.74 |
Total Drug Medicare PaymentAmount |
179.46 |
Total Drug Medicare Standardized Payment Amount |
179.46 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
625 |
Number Of Medicare Beneficiaries With Medical Services |
63 |
Total Medical Submitted Charge Amount |
129850 |
Total Medical Medicare Allowed Amount |
86816.53 |
Total Medical Medicare Payment Amount |
62607.71 |
Total Medical Medicare Standardized Payment Amount |
63627.94 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
24 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
23 |
Number Of Male Beneficiaries |
40 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
68 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
27 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
70 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0085 |