| National Provider Identifier [NPI]: | 1669466538 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | HIMANSHU |
| 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 | 81 HIGHLAND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 019702714 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 8311 |
| Number Of Medicare Beneficiaries | 2963 |
| Total Submitted Charge Amount | 625602.48 |
| Total Medicare Allowed Amount | 172317.1 |
| Total Medicare Payment Amount | 134111.97 |
| Total Medicare Standardized Payment Amount | 132433.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3528 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 11820 |
| Total Drug Medicare AllowedAmount | 851.64 |
| Total Drug Medicare PaymentAmount | 667.62 |
| Total Drug Medicare Standardized Payment Amount | 667.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 4783 |
| Number Of Medicare Beneficiaries With Medical Services | 2963 |
| Total Medical Submitted Charge Amount | 613782.48 |
| Total Medical Medicare Allowed Amount | 171465.46 |
| Total Medical Medicare Payment Amount | 133444.35 |
| Total Medical Medicare Standardized Payment Amount | 131765.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 590 |
| Number Of Beneficiaries Age 65 to 74 | 1041 |
| Number Of Beneficiaries Age 75 to 84 | 824 |
| Number Of Beneficiaries Age Greater 84 | 508 |
| Number Of Female Beneficiaries | 2030 |
| Number Of Male Beneficiaries | 933 |
| Number Of Non Hispanic White Beneficiaries | 2608 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 214 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1943 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1020 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5709 |