| National Provider Identifier [NPI]: | 1699926824 |
| Last Name Of The Provider | BANSAL |
| First Name Of The Provider | ANISH |
| 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 | 1 HURLEY PLZ |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | FLINT |
| Zip Code Of The Provider | 485035902 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 237 |
| Number Of Services | 14299 |
| Number Of Medicare Beneficiaries | 2072 |
| Total Submitted Charge Amount | 511002 |
| Total Medicare Allowed Amount | 199825.19 |
| Total Medicare Payment Amount | 152321.61 |
| Total Medicare Standardized Payment Amount | 162986.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 11141 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 23556 |
| Total Drug Medicare AllowedAmount | 2137.04 |
| Total Drug Medicare PaymentAmount | 1659.73 |
| Total Drug Medicare Standardized Payment Amount | 1659.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 236 |
| Number Of Medical Services | 3158 |
| Number Of Medicare Beneficiaries With Medical Services | 2072 |
| Total Medical Submitted Charge Amount | 487446 |
| Total Medical Medicare Allowed Amount | 197688.15 |
| Total Medical Medicare Payment Amount | 150661.88 |
| Total Medical Medicare Standardized Payment Amount | 161326.89 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 644 |
| Number Of Beneficiaries Age 65 to 74 | 700 |
| Number Of Beneficiaries Age 75 to 84 | 517 |
| Number Of Beneficiaries Age Greater 84 | 211 |
| Number Of Female Beneficiaries | 1173 |
| Number Of Male Beneficiaries | 899 |
| Number Of Non Hispanic White Beneficiaries | 1229 |
| Number Of Black or African American Beneficiaries | 788 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 747 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.1738 |