| National Provider Identifier [NPI]: | 1790708550 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | DEEPA |
| 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 | 3845 W 4700 S |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAYLORSVILLE |
| Zip Code Of The Provider | 841183454 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 758 |
| Number Of Medicare Beneficiaries | 310 |
| Total Submitted Charge Amount | 56762 |
| Total Medicare Allowed Amount | 37069.15 |
| Total Medicare Payment Amount | 24629.98 |
| Total Medicare Standardized Payment Amount | 26826.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 141 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 1985 |
| Total Drug Medicare AllowedAmount | 209.22 |
| Total Drug Medicare PaymentAmount | 160.88 |
| Total Drug Medicare Standardized Payment Amount | 160.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 617 |
| Number Of Medicare Beneficiaries With Medical Services | 310 |
| Total Medical Submitted Charge Amount | 54777 |
| Total Medical Medicare Allowed Amount | 36859.93 |
| Total Medical Medicare Payment Amount | 24469.1 |
| Total Medical Medicare Standardized Payment Amount | 26665.99 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 207 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 270 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 256 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1468 |