| National Provider Identifier [NPI]: | 1194981985 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | ANKUR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 E WACKER DR |
| Street Address 2 Of The Provider | SUITE 3150 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606011474 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1763 |
| Number Of Medicare Beneficiaries | 315 |
| Total Submitted Charge Amount | 689434.15 |
| Total Medicare Allowed Amount | 209749.6 |
| Total Medicare Payment Amount | 162775.4 |
| Total Medicare Standardized Payment Amount | 162243.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 123 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 35699 |
| Total Drug Medicare AllowedAmount | 24967.31 |
| Total Drug Medicare PaymentAmount | 19574.27 |
| Total Drug Medicare Standardized Payment Amount | 19574.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1640 |
| Number Of Medicare Beneficiaries With Medical Services | 315 |
| Total Medical Submitted Charge Amount | 653735.15 |
| Total Medical Medicare Allowed Amount | 184782.29 |
| Total Medical Medicare Payment Amount | 143201.13 |
| Total Medical Medicare Standardized Payment Amount | 142669.43 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 131 |
| Number Of Non Hispanic White Beneficiaries | 216 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 241 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5484 |