| National Provider Identifier [NPI]: | 1487761912 |
| Last Name Of The Provider | KAPUR |
| First Name Of The Provider | CHANDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2636 EASTERN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PLYMOUTH |
| Zip Code Of The Provider | 53073 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 2600 |
| Number Of Medicare Beneficiaries | 284 |
| Total Submitted Charge Amount | 421252.75 |
| Total Medicare Allowed Amount | 125508.12 |
| Total Medicare Payment Amount | 95736.21 |
| Total Medicare Standardized Payment Amount | 99178.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 151 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 7798.75 |
| Total Drug Medicare AllowedAmount | 4071.29 |
| Total Drug Medicare PaymentAmount | 3731.73 |
| Total Drug Medicare Standardized Payment Amount | 3731.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2449 |
| Number Of Medicare Beneficiaries With Medical Services | 284 |
| Total Medical Submitted Charge Amount | 413454 |
| Total Medical Medicare Allowed Amount | 121436.83 |
| Total Medical Medicare Payment Amount | 92004.48 |
| Total Medical Medicare Standardized Payment Amount | 95446.52 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | 272 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.058 |