| National Provider Identifier [NPI]: | 1467656041 |
| Last Name Of The Provider | POPURI |
| First Name Of The Provider | DEEPA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2650 RIDGE AVE |
| Street Address 2 Of The Provider | 2650 RIDGE AVE |
| City Of The Provider | EVANSTON |
| Zip Code Of The Provider | 602011718 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 6345 |
| Number Of Medicare Beneficiaries | 3712 |
| Total Submitted Charge Amount | 1023543 |
| Total Medicare Allowed Amount | 224222.54 |
| Total Medicare Payment Amount | 164291.14 |
| Total Medicare Standardized Payment Amount | 157804.72 |
| 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 | 200 |
| Number Of Medical Services | 6345 |
| Number Of Medicare Beneficiaries With Medical Services | 3712 |
| Total Medical Submitted Charge Amount | 1023543 |
| Total Medical Medicare Allowed Amount | 224222.54 |
| Total Medical Medicare Payment Amount | 164291.14 |
| Total Medical Medicare Standardized Payment Amount | 157804.72 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 423 |
| Number Of Beneficiaries Age 65 to 74 | 1231 |
| Number Of Beneficiaries Age 75 to 84 | 1180 |
| Number Of Beneficiaries Age Greater 84 | 878 |
| Number Of Female Beneficiaries | 2297 |
| Number Of Male Beneficiaries | 1415 |
| Number Of Non Hispanic White Beneficiaries | 3182 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | 103 |
| Number Of Hispanic Beneficiaries | 169 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2962 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 750 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8174 |