| National Provider Identifier [NPI]: | 1972504520 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | RAVI |
| 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 | 8737 VAN NUYS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PANORAMA CITY |
| Zip Code Of The Provider | 914022401 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 8674 |
| Number Of Medicare Beneficiaries | 1388 |
| Total Submitted Charge Amount | 1124209 |
| Total Medicare Allowed Amount | 838092.49 |
| Total Medicare Payment Amount | 631623.93 |
| Total Medicare Standardized Payment Amount | 582555.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1973 |
| Number Of Medicare Beneficiaries With Drug Services | 154 |
| Total Drug Submitted ChargeAmount | 51710 |
| Total Drug Medicare AllowedAmount | 27531.42 |
| Total Drug Medicare PaymentAmount | 21584.49 |
| Total Drug Medicare Standardized Payment Amount | 21584.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 6701 |
| Number Of Medicare Beneficiaries With Medical Services | 1388 |
| Total Medical Submitted Charge Amount | 1072499 |
| Total Medical Medicare Allowed Amount | 810561.07 |
| Total Medical Medicare Payment Amount | 610039.44 |
| Total Medical Medicare Standardized Payment Amount | 560971.3 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 383 |
| Number Of Beneficiaries Age 75 to 84 | 469 |
| Number Of Beneficiaries Age Greater 84 | 342 |
| Number Of Female Beneficiaries | 821 |
| Number Of Male Beneficiaries | 567 |
| Number Of Non Hispanic White Beneficiaries | 491 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | 220 |
| Number Of Hispanic Beneficiaries | 575 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 254 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1134 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.7159 |