| National Provider Identifier [NPI]: | 1235197468 |
| Last Name Of The Provider | JHAVERI |
| First Name Of The Provider | MIRAL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1725 W HARRISON ST |
| Street Address 2 Of The Provider | SUITE 456 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606123841 |
| 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 | 83 |
| Number Of Services | 16278 |
| Number Of Medicare Beneficiaries | 2240 |
| Total Submitted Charge Amount | 2917210 |
| Total Medicare Allowed Amount | 404044.83 |
| Total Medicare Payment Amount | 311279.76 |
| Total Medicare Standardized Payment Amount | 307132.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 12947 |
| Number Of Medicare Beneficiaries With Drug Services | 371 |
| Total Drug Submitted ChargeAmount | 91060 |
| Total Drug Medicare AllowedAmount | 12423.77 |
| Total Drug Medicare PaymentAmount | 9646.83 |
| Total Drug Medicare Standardized Payment Amount | 9646.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 3331 |
| Number Of Medicare Beneficiaries With Medical Services | 2239 |
| Total Medical Submitted Charge Amount | 2826150 |
| Total Medical Medicare Allowed Amount | 391621.06 |
| Total Medical Medicare Payment Amount | 301632.93 |
| Total Medical Medicare Standardized Payment Amount | 297485.35 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 534 |
| Number Of Beneficiaries Age 65 to 74 | 904 |
| Number Of Beneficiaries Age 75 to 84 | 591 |
| Number Of Beneficiaries Age Greater 84 | 211 |
| Number Of Female Beneficiaries | 1371 |
| Number Of Male Beneficiaries | 869 |
| Number Of Non Hispanic White Beneficiaries | 1069 |
| Number Of Black or African American Beneficiaries | 773 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 323 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1421 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 819 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.8099 |