| National Provider Identifier [NPI]: | 1770518425 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | SURAJ |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. FACP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3 PLAZA DR |
| Street Address 2 Of The Provider | SUITE 4 |
| City Of The Provider | TOMS RIVER |
| Zip Code Of The Provider | 087573759 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 1099 |
| Number Of Medicare Beneficiaries | 488 |
| Total Submitted Charge Amount | 171134.41 |
| Total Medicare Allowed Amount | 104457.85 |
| Total Medicare Payment Amount | 81536.19 |
| Total Medicare Standardized Payment Amount | 77661 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 15 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 730 |
| Total Drug Medicare AllowedAmount | 355.46 |
| Total Drug Medicare PaymentAmount | 348.32 |
| Total Drug Medicare Standardized Payment Amount | 348.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1084 |
| Number Of Medicare Beneficiaries With Medical Services | 488 |
| Total Medical Submitted Charge Amount | 170404.41 |
| Total Medical Medicare Allowed Amount | 104102.39 |
| Total Medical Medicare Payment Amount | 81187.87 |
| Total Medical Medicare Standardized Payment Amount | 77312.68 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 272 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 443 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 375 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.1552 |