| National Provider Identifier [NPI]: | 1942296462 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | SHODHAN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7860 BURR ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SCHERERVILLE |
| Zip Code Of The Provider | 463753402 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 4565 |
| Number Of Medicare Beneficiaries | 1687 |
| Total Submitted Charge Amount | 497471.75 |
| Total Medicare Allowed Amount | 163071.65 |
| Total Medicare Payment Amount | 127365.31 |
| Total Medicare Standardized Payment Amount | 136779.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1928 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 5754 |
| Total Drug Medicare AllowedAmount | 1184.47 |
| Total Drug Medicare PaymentAmount | 876.71 |
| Total Drug Medicare Standardized Payment Amount | 876.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 185 |
| Number Of Medical Services | 2637 |
| Number Of Medicare Beneficiaries With Medical Services | 1687 |
| Total Medical Submitted Charge Amount | 491717.75 |
| Total Medical Medicare Allowed Amount | 161887.18 |
| Total Medical Medicare Payment Amount | 126488.6 |
| Total Medical Medicare Standardized Payment Amount | 135902.49 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 454 |
| Number Of Beneficiaries Age 65 to 74 | 598 |
| Number Of Beneficiaries Age 75 to 84 | 445 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 1094 |
| Number Of Male Beneficiaries | 593 |
| Number Of Non Hispanic White Beneficiaries | 728 |
| Number Of Black or African American Beneficiaries | 867 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1111 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 576 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.9766 |