| National Provider Identifier [NPI]: | 1699761437 |
| Last Name Of The Provider | PURUSH |
| First Name Of The Provider | AJITH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MBBS, MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 722 N MONTEZUMA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRESCOTT |
| Zip Code Of The Provider | 863012002 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 12099.5 |
| Number Of Medicare Beneficiaries | 1349 |
| Total Submitted Charge Amount | 1042954.37 |
| Total Medicare Allowed Amount | 842723.75 |
| Total Medicare Payment Amount | 644776.38 |
| Total Medicare Standardized Payment Amount | 645771.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 880.5 |
| Number Of Medicare Beneficiaries With Drug Services | 167 |
| Total Drug Submitted ChargeAmount | 8129 |
| Total Drug Medicare AllowedAmount | 2140.02 |
| Total Drug Medicare PaymentAmount | 1704.73 |
| Total Drug Medicare Standardized Payment Amount | 1704.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 11219 |
| Number Of Medicare Beneficiaries With Medical Services | 1349 |
| Total Medical Submitted Charge Amount | 1034825.37 |
| Total Medical Medicare Allowed Amount | 840583.73 |
| Total Medical Medicare Payment Amount | 643071.65 |
| Total Medical Medicare Standardized Payment Amount | 644066.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 705 |
| Number Of Beneficiaries Age 75 to 84 | 414 |
| Number Of Beneficiaries Age Greater 84 | 181 |
| Number Of Female Beneficiaries | 746 |
| Number Of Male Beneficiaries | 603 |
| Number Of Non Hispanic White Beneficiaries | 1277 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1313 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0022 |