| National Provider Identifier [NPI]: | 1255613527 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | VIKAS |
| 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 | 4371 NARROW LANE RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MONTGOMERY |
| Zip Code Of The Provider | 361162971 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2226 |
| Number Of Medicare Beneficiaries | 600 |
| Total Submitted Charge Amount | 312233.47 |
| Total Medicare Allowed Amount | 156729.82 |
| Total Medicare Payment Amount | 116350.17 |
| Total Medicare Standardized Payment Amount | 124897.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 331 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 664.96 |
| Total Drug Medicare AllowedAmount | 450.43 |
| Total Drug Medicare PaymentAmount | 418.62 |
| Total Drug Medicare Standardized Payment Amount | 418.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1895 |
| Number Of Medicare Beneficiaries With Medical Services | 600 |
| Total Medical Submitted Charge Amount | 311568.51 |
| Total Medical Medicare Allowed Amount | 156279.39 |
| Total Medical Medicare Payment Amount | 115931.55 |
| Total Medical Medicare Standardized Payment Amount | 124479.21 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 233 |
| Number Of Beneficiaries Age 65 to 74 | 171 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 382 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 283 |
| Number Of Black or African American Beneficiaries | 306 |
| 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 | 298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 302 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6004 |