| National Provider Identifier [NPI]: | 1811073323 |
| Last Name Of The Provider | KUPPAHALLY |
| First Name Of The Provider | SUMAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2585 SAMARITAN DR |
| Street Address 2 Of The Provider | 303 |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951244107 |
| 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 | 47 |
| Number Of Services | 4373 |
| Number Of Medicare Beneficiaries | 549 |
| Total Submitted Charge Amount | 472280.2 |
| Total Medicare Allowed Amount | 389256.57 |
| Total Medicare Payment Amount | 291286.36 |
| Total Medicare Standardized Payment Amount | 248937.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 393 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 7245 |
| Total Drug Medicare AllowedAmount | 3678.51 |
| Total Drug Medicare PaymentAmount | 2883.92 |
| Total Drug Medicare Standardized Payment Amount | 2883.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3980 |
| Number Of Medicare Beneficiaries With Medical Services | 549 |
| Total Medical Submitted Charge Amount | 465035.2 |
| Total Medical Medicare Allowed Amount | 385578.06 |
| Total Medical Medicare Payment Amount | 288402.44 |
| Total Medical Medicare Standardized Payment Amount | 246054.02 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 205 |
| Number Of Beneficiaries Age Greater 84 | 137 |
| Number Of Female Beneficiaries | 279 |
| Number Of Male Beneficiaries | 270 |
| Number Of Non Hispanic White Beneficiaries | 448 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 474 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6203 |