| National Provider Identifier [NPI]: | 1023063419 |
| Last Name Of The Provider | MALPANI |
| First Name Of The Provider | AJAY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2200 FORT JESSE RD |
| Street Address 2 Of The Provider | SUITE 280 |
| City Of The Provider | NORMAL |
| Zip Code Of The Provider | 617616286 |
| 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 | 184 |
| Number Of Services | 6754 |
| Number Of Medicare Beneficiaries | 2805 |
| Total Submitted Charge Amount | 789144.5 |
| Total Medicare Allowed Amount | 195712.98 |
| Total Medicare Payment Amount | 154951.82 |
| Total Medicare Standardized Payment Amount | 161837.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2010 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 2873.5 |
| Total Drug Medicare AllowedAmount | 663.96 |
| Total Drug Medicare PaymentAmount | 506.85 |
| Total Drug Medicare Standardized Payment Amount | 506.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 181 |
| Number Of Medical Services | 4744 |
| Number Of Medicare Beneficiaries With Medical Services | 2805 |
| Total Medical Submitted Charge Amount | 786271 |
| Total Medical Medicare Allowed Amount | 195049.02 |
| Total Medical Medicare Payment Amount | 154444.97 |
| Total Medical Medicare Standardized Payment Amount | 161330.64 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 442 |
| Number Of Beneficiaries Age 65 to 74 | 1202 |
| Number Of Beneficiaries Age 75 to 84 | 762 |
| Number Of Beneficiaries Age Greater 84 | 399 |
| Number Of Female Beneficiaries | 1866 |
| Number Of Male Beneficiaries | 939 |
| Number Of Non Hispanic White Beneficiaries | 2615 |
| Number Of Black or African American Beneficiaries | 124 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2247 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 558 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3794 |