| National Provider Identifier [NPI]: | 1336342153 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | NIDHI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1654 UPHAM DR |
| Street Address 2 Of The Provider | OSU MEDICAL CENTER 630 MEANS HALL |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 43210 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 2911 |
| Number Of Medicare Beneficiaries | 2011 |
| Total Submitted Charge Amount | 163432 |
| Total Medicare Allowed Amount | 45609.61 |
| Total Medicare Payment Amount | 33335.9 |
| Total Medicare Standardized Payment Amount | 34492.7 |
| 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 | 83 |
| Number Of Medical Services | 2911 |
| Number Of Medicare Beneficiaries With Medical Services | 2011 |
| Total Medical Submitted Charge Amount | 163432 |
| Total Medical Medicare Allowed Amount | 45609.61 |
| Total Medical Medicare Payment Amount | 33335.9 |
| Total Medical Medicare Standardized Payment Amount | 34492.7 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 784 |
| Number Of Beneficiaries Age 65 to 74 | 709 |
| Number Of Beneficiaries Age 75 to 84 | 382 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 1114 |
| Number Of Male Beneficiaries | 897 |
| Number Of Non Hispanic White Beneficiaries | 1468 |
| Number Of Black or African American Beneficiaries | 454 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 800 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0314 |