| National Provider Identifier [NPI]: | 1164415105 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | KAMAL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19335 ALLEN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROWNSTOWN TWP |
| Zip Code Of The Provider | 481831003 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 6025 |
| Number Of Medicare Beneficiaries | 2004 |
| Total Submitted Charge Amount | 1407265 |
| Total Medicare Allowed Amount | 849558.83 |
| Total Medicare Payment Amount | 619480.61 |
| Total Medicare Standardized Payment Amount | 605241.95 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 328 |
| Number Of Beneficiaries Age 65 to 74 | 847 |
| Number Of Beneficiaries Age 75 to 84 | 604 |
| Number Of Beneficiaries Age Greater 84 | 225 |
| Number Of Female Beneficiaries | 1192 |
| Number Of Male Beneficiaries | 812 |
| Number Of Non Hispanic White Beneficiaries | 1409 |
| Number Of Black or African American Beneficiaries | 293 |
| Number Of AsianPacific Islander Beneficiaries | 210 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1474 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 530 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3913 |