| National Provider Identifier [NPI]: | 1376632638 |
| Last Name Of The Provider | PUPPALA |
| First Name Of The Provider | SHILPA |
| 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 | 836 W WELLINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 60657 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 2775 |
| Number Of Medicare Beneficiaries | 1573 |
| Total Submitted Charge Amount | 269684 |
| Total Medicare Allowed Amount | 79945.99 |
| Total Medicare Payment Amount | 62788.42 |
| Total Medicare Standardized Payment Amount | 59591.03 |
| 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 | 129 |
| Number Of Medical Services | 2775 |
| Number Of Medicare Beneficiaries With Medical Services | 1573 |
| Total Medical Submitted Charge Amount | 269684 |
| Total Medical Medicare Allowed Amount | 79945.99 |
| Total Medical Medicare Payment Amount | 62788.42 |
| Total Medical Medicare Standardized Payment Amount | 59591.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 717 |
| Number Of Beneficiaries Age 75 to 84 | 530 |
| Number Of Beneficiaries Age Greater 84 | 207 |
| Number Of Female Beneficiaries | 1115 |
| Number Of Male Beneficiaries | 458 |
| Number Of Non Hispanic White Beneficiaries | 1455 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1394 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 179 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3639 |