| National Provider Identifier [NPI]: | 1174578843 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | MOHINA |
| 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 | 1870 W WINCHESTER RD STE 248 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LIBERTYVILLE |
| Zip Code Of The Provider | 600485360 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 4704 |
| Number Of Medicare Beneficiaries | 631 |
| Total Submitted Charge Amount | 854079.55 |
| Total Medicare Allowed Amount | 425808.06 |
| Total Medicare Payment Amount | 315146.55 |
| Total Medicare Standardized Payment Amount | 299260.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 166 |
| Number Of Medicare Beneficiaries With Drug Services | 123 |
| Total Drug Submitted ChargeAmount | 10400 |
| Total Drug Medicare AllowedAmount | 4334.07 |
| Total Drug Medicare PaymentAmount | 4234.53 |
| Total Drug Medicare Standardized Payment Amount | 4234.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 4538 |
| Number Of Medicare Beneficiaries With Medical Services | 631 |
| Total Medical Submitted Charge Amount | 843679.55 |
| Total Medical Medicare Allowed Amount | 421473.99 |
| Total Medical Medicare Payment Amount | 310912.02 |
| Total Medical Medicare Standardized Payment Amount | 295025.5 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 202 |
| Number Of Beneficiaries Age Greater 84 | 173 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 514 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 405 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 226 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7587 |