| National Provider Identifier [NPI]: | 1467424382 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | SHAILESH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 580 W 8TH ST |
| Street Address 2 Of The Provider | UFJP OPHTHALMOLOGY |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322096533 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 8993 |
| Number Of Medicare Beneficiaries | 1326 |
| Total Submitted Charge Amount | 2590909.79 |
| Total Medicare Allowed Amount | 1002645.46 |
| Total Medicare Payment Amount | 771240.39 |
| Total Medicare Standardized Payment Amount | 761783.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 819 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 79432 |
| Total Drug Medicare AllowedAmount | 47907.3 |
| Total Drug Medicare PaymentAmount | 37444.01 |
| Total Drug Medicare Standardized Payment Amount | 37444.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 8174 |
| Number Of Medicare Beneficiaries With Medical Services | 1326 |
| Total Medical Submitted Charge Amount | 2511477.79 |
| Total Medical Medicare Allowed Amount | 954738.16 |
| Total Medical Medicare Payment Amount | 733796.38 |
| Total Medical Medicare Standardized Payment Amount | 724339.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 303 |
| Number Of Beneficiaries Age 65 to 74 | 512 |
| Number Of Beneficiaries Age 75 to 84 | 347 |
| Number Of Beneficiaries Age Greater 84 | 164 |
| Number Of Female Beneficiaries | 838 |
| Number Of Male Beneficiaries | 488 |
| Number Of Non Hispanic White Beneficiaries | 576 |
| Number Of Black or African American Beneficiaries | 558 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 137 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 613 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 713 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7391 |