| National Provider Identifier [NPI]: | 1932151628 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | RAHUL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 3460 |
| Number Of Medicare Beneficiaries | 2098 |
| Total Submitted Charge Amount | 395129 |
| Total Medicare Allowed Amount | 99927.39 |
| Total Medicare Payment Amount | 77978.9 |
| Total Medicare Standardized Payment Amount | 78581.13 |
| 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 | 146 |
| Number Of Medical Services | 3460 |
| Number Of Medicare Beneficiaries With Medical Services | 2098 |
| Total Medical Submitted Charge Amount | 395129 |
| Total Medical Medicare Allowed Amount | 99927.39 |
| Total Medical Medicare Payment Amount | 77978.9 |
| Total Medical Medicare Standardized Payment Amount | 78581.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 311 |
| Number Of Beneficiaries Age 65 to 74 | 798 |
| Number Of Beneficiaries Age 75 to 84 | 621 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 1419 |
| Number Of Male Beneficiaries | 679 |
| Number Of Non Hispanic White Beneficiaries | 1551 |
| Number Of Black or African American Beneficiaries | 422 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1660 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 438 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5897 |