| National Provider Identifier [NPI]: | 1720055379 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | SANDEEP |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 103 MCKNIGHT DR |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 450444890 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 132 |
| Number Of Services | 10792 |
| Number Of Medicare Beneficiaries | 1158 |
| Total Submitted Charge Amount | 1298374.11 |
| Total Medicare Allowed Amount | 822658.62 |
| Total Medicare Payment Amount | 621026.63 |
| Total Medicare Standardized Payment Amount | 647259.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3193 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 25693.4 |
| Total Drug Medicare AllowedAmount | 9311.99 |
| Total Drug Medicare PaymentAmount | 7300.48 |
| Total Drug Medicare Standardized Payment Amount | 7300.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 7599 |
| Number Of Medicare Beneficiaries With Medical Services | 1158 |
| Total Medical Submitted Charge Amount | 1272680.71 |
| Total Medical Medicare Allowed Amount | 813346.63 |
| Total Medical Medicare Payment Amount | 613726.15 |
| Total Medical Medicare Standardized Payment Amount | 639958.69 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 365 |
| Number Of Beneficiaries Age 75 to 84 | 409 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 583 |
| Number Of Male Beneficiaries | 575 |
| Number Of Non Hispanic White Beneficiaries | 1106 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 995 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 163 |
| Percent Of With Atrial Fibrillation | 39 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8066 |