| National Provider Identifier [NPI]: | 1407823834 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | AMIT |
| 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 | 8401 DATAPOINT DR |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782295900 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 234 |
| Number Of Services | 5677 |
| Number Of Medicare Beneficiaries | 2088 |
| Total Submitted Charge Amount | 692197.92 |
| Total Medicare Allowed Amount | 186702.84 |
| Total Medicare Payment Amount | 144422.82 |
| Total Medicare Standardized Payment Amount | 153643.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2627 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1928.5 |
| Total Drug Medicare AllowedAmount | 814.45 |
| Total Drug Medicare PaymentAmount | 577.78 |
| Total Drug Medicare Standardized Payment Amount | 577.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 231 |
| Number Of Medical Services | 3050 |
| Number Of Medicare Beneficiaries With Medical Services | 2087 |
| Total Medical Submitted Charge Amount | 690269.42 |
| Total Medical Medicare Allowed Amount | 185888.39 |
| Total Medical Medicare Payment Amount | 143845.04 |
| Total Medical Medicare Standardized Payment Amount | 153065.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 427 |
| Number Of Beneficiaries Age 65 to 74 | 726 |
| Number Of Beneficiaries Age 75 to 84 | 569 |
| Number Of Beneficiaries Age Greater 84 | 366 |
| Number Of Female Beneficiaries | 1175 |
| Number Of Male Beneficiaries | 913 |
| Number Of Non Hispanic White Beneficiaries | 1201 |
| Number Of Black or African American Beneficiaries | 123 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 731 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1519 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 569 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3863 |