| National Provider Identifier [NPI]: | 1326028309 |
| Last Name Of The Provider | PUROHIT |
| First Name Of The Provider | DIVYESH |
| 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 | 557 W BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHELBURN |
| Zip Code Of The Provider | 47879 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 6262.5 |
| Number Of Medicare Beneficiaries | 1043 |
| Total Submitted Charge Amount | 699851 |
| Total Medicare Allowed Amount | 370169.31 |
| Total Medicare Payment Amount | 253400.84 |
| Total Medicare Standardized Payment Amount | 271625.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 907.5 |
| Number Of Medicare Beneficiaries With Drug Services | 279 |
| Total Drug Submitted ChargeAmount | 16555 |
| Total Drug Medicare AllowedAmount | 4725.75 |
| Total Drug Medicare PaymentAmount | 3950.03 |
| Total Drug Medicare Standardized Payment Amount | 3950.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 5355 |
| Number Of Medicare Beneficiaries With Medical Services | 1043 |
| Total Medical Submitted Charge Amount | 683296 |
| Total Medical Medicare Allowed Amount | 365443.56 |
| Total Medical Medicare Payment Amount | 249450.81 |
| Total Medical Medicare Standardized Payment Amount | 267675.18 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 225 |
| Number Of Beneficiaries Age 65 to 74 | 415 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 583 |
| Number Of Male Beneficiaries | 460 |
| Number Of Non Hispanic White Beneficiaries | 1027 |
| Number Of Black or African American Beneficiaries | |
| 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 | 766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 277 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3976 |