| National Provider Identifier [NPI]: | 1073729125 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | GARIMA |
| 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 | 3124 E STATE BLVD STE 6A |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468054763 |
| 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 | 50 |
| Number Of Services | 5780 |
| Number Of Medicare Beneficiaries | 976 |
| Total Submitted Charge Amount | 684575 |
| Total Medicare Allowed Amount | 338671.37 |
| Total Medicare Payment Amount | 258619.08 |
| Total Medicare Standardized Payment Amount | 271665.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1676 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 10928 |
| Total Drug Medicare AllowedAmount | 6336.79 |
| Total Drug Medicare PaymentAmount | 4878.2 |
| Total Drug Medicare Standardized Payment Amount | 4878.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 4104 |
| Number Of Medicare Beneficiaries With Medical Services | 976 |
| Total Medical Submitted Charge Amount | 673647 |
| Total Medical Medicare Allowed Amount | 332334.58 |
| Total Medical Medicare Payment Amount | 253740.88 |
| Total Medical Medicare Standardized Payment Amount | 266787.35 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 293 |
| Number Of Beneficiaries Age 65 to 74 | 307 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 506 |
| Number Of Male Beneficiaries | 470 |
| Number Of Non Hispanic White Beneficiaries | 798 |
| Number Of Black or African American Beneficiaries | 137 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 599 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 377 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 67 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 4.3842 |