| National Provider Identifier [NPI]: | 1275735235 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | SHIVAM |
| 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 | 1000 E MOUNTAIN DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILKES BARRE |
| Zip Code Of The Provider | 187110027 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 7424 |
| Number Of Medicare Beneficiaries | 4655 |
| Total Submitted Charge Amount | 1292893.8 |
| Total Medicare Allowed Amount | 157321.73 |
| Total Medicare Payment Amount | 115801.74 |
| Total Medicare Standardized Payment Amount | 120979.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 655 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3883.8 |
| Total Drug Medicare AllowedAmount | 388.1 |
| Total Drug Medicare PaymentAmount | 279.35 |
| Total Drug Medicare Standardized Payment Amount | 279.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 6769 |
| Number Of Medicare Beneficiaries With Medical Services | 4655 |
| Total Medical Submitted Charge Amount | 1289010 |
| Total Medical Medicare Allowed Amount | 156933.63 |
| Total Medical Medicare Payment Amount | 115522.39 |
| Total Medical Medicare Standardized Payment Amount | 120700.33 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1139 |
| Number Of Beneficiaries Age 65 to 74 | 1607 |
| Number Of Beneficiaries Age 75 to 84 | 1259 |
| Number Of Beneficiaries Age Greater 84 | 650 |
| Number Of Female Beneficiaries | 2482 |
| Number Of Male Beneficiaries | 2173 |
| Number Of Non Hispanic White Beneficiaries | 4416 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 92 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1497 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9066 |