National Provider Identifier [NPI]: |
1053323089 |
Last Name Of The Provider |
KANSAL |
First Name Of The Provider |
SUNIL |
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 |
18820 E BAGLEY ROAD |
Street Address 2 Of The Provider |
SUITE 106 |
City Of The Provider |
MIDDLEBURG HEIGHTS |
Zip Code Of The Provider |
441303325 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1649 |
Number Of Medicare Beneficiaries |
495 |
Total Submitted Charge Amount |
168038 |
Total Medicare Allowed Amount |
139545.48 |
Total Medicare Payment Amount |
103277.02 |
Total Medicare Standardized Payment Amount |
114468.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
33 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
978 |
Total Drug Medicare AllowedAmount |
460.6 |
Total Drug Medicare PaymentAmount |
445.47 |
Total Drug Medicare Standardized Payment Amount |
445.47 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
1616 |
Number Of Medicare Beneficiaries With Medical Services |
495 |
Total Medical Submitted Charge Amount |
167060 |
Total Medical Medicare Allowed Amount |
139084.88 |
Total Medical Medicare Payment Amount |
102831.55 |
Total Medical Medicare Standardized Payment Amount |
114022.71 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
99 |
Number Of Female Beneficiaries |
278 |
Number Of Male Beneficiaries |
217 |
Number Of Non Hispanic White Beneficiaries |
435 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
17 |
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 |
336 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
42 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.7456 |