| National Provider Identifier [NPI]: | 1033399860 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | NIDHI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 751 S BASCOM AVE |
| Street Address 2 Of The Provider | DI |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951282604 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 190 |
| Number Of Services | 7923 |
| Number Of Medicare Beneficiaries | 4499 |
| Total Submitted Charge Amount | 898504.56 |
| Total Medicare Allowed Amount | 228967.56 |
| Total Medicare Payment Amount | 170312.33 |
| Total Medicare Standardized Payment Amount | 164176.31 |
| 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 | 190 |
| Number Of Medical Services | 7923 |
| Number Of Medicare Beneficiaries With Medical Services | 4499 |
| Total Medical Submitted Charge Amount | 898504.56 |
| Total Medical Medicare Allowed Amount | 228967.56 |
| Total Medical Medicare Payment Amount | 170312.33 |
| Total Medical Medicare Standardized Payment Amount | 164176.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 804 |
| Number Of Beneficiaries Age 65 to 74 | 1587 |
| Number Of Beneficiaries Age 75 to 84 | 1336 |
| Number Of Beneficiaries Age Greater 84 | 772 |
| Number Of Female Beneficiaries | 2792 |
| Number Of Male Beneficiaries | 1707 |
| Number Of Non Hispanic White Beneficiaries | 2147 |
| Number Of Black or African American Beneficiaries | 237 |
| Number Of AsianPacific Islander Beneficiaries | 822 |
| Number Of Hispanic Beneficiaries | 1197 |
| Number Of American Indian Alaska Native Beneficiaries | 16 |
| Number Of Beneficiaries With Race Not Else where Classified | 80 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2302 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2197 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8347 |