| National Provider Identifier [NPI]: | 1730345018 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | PUNJ |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 270 WEST LOOP ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WHEATON |
| Zip Code Of The Provider | 60189 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 5536 |
| Number Of Medicare Beneficiaries | 3231 |
| Total Submitted Charge Amount | 969803 |
| Total Medicare Allowed Amount | 259153.48 |
| Total Medicare Payment Amount | 201787.64 |
| Total Medicare Standardized Payment Amount | 190894.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 5536 |
| Number Of Medicare Beneficiaries With Medical Services | 3231 |
| Total Medical Submitted Charge Amount | 969803 |
| Total Medical Medicare Allowed Amount | 259153.48 |
| Total Medical Medicare Payment Amount | 201787.64 |
| Total Medical Medicare Standardized Payment Amount | 190894.78 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 211 |
| Number Of Beneficiaries Age 65 to 74 | 1341 |
| Number Of Beneficiaries Age 75 to 84 | 1127 |
| Number Of Beneficiaries Age Greater 84 | 552 |
| Number Of Female Beneficiaries | 2398 |
| Number Of Male Beneficiaries | 833 |
| Number Of Non Hispanic White Beneficiaries | 3030 |
| Number Of Black or African American Beneficiaries | 56 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3014 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 217 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.3744 |