| National Provider Identifier [NPI]: | 1750320461 |
| Last Name Of The Provider | PUREWAL |
| First Name Of The Provider | MITESWAR |
| 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 | 700 E TOWNSHIP LINE RD |
| Street Address 2 Of The Provider | FIRST FLOOR |
| City Of The Provider | HAVERTOWN |
| Zip Code Of The Provider | 190835733 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 2785 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 624841 |
| Total Medicare Allowed Amount | 179075.13 |
| Total Medicare Payment Amount | 143152.88 |
| Total Medicare Standardized Payment Amount | 135645.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 904 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 12414 |
| Total Drug Medicare AllowedAmount | 6210.09 |
| Total Drug Medicare PaymentAmount | 4868.74 |
| Total Drug Medicare Standardized Payment Amount | 4868.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1881 |
| Number Of Medicare Beneficiaries With Medical Services | 406 |
| Total Medical Submitted Charge Amount | 612427 |
| Total Medical Medicare Allowed Amount | 172865.04 |
| Total Medical Medicare Payment Amount | 138284.14 |
| Total Medical Medicare Standardized Payment Amount | 130776.61 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 267 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 19 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 161 |
| Number Of Non Hispanic White Beneficiaries | 265 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 226 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 181 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4251 |