| National Provider Identifier [NPI]: | 1508196742 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | AVINDER |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1420 RENAISSANCE DR |
| Street Address 2 Of The Provider | SUITE 207 |
| City Of The Provider | PARK RIDGE |
| Zip Code Of The Provider | 600681330 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 6058 |
| Number Of Medicare Beneficiaries | 826 |
| Total Submitted Charge Amount | 693168 |
| Total Medicare Allowed Amount | 519695.29 |
| Total Medicare Payment Amount | 404804.28 |
| Total Medicare Standardized Payment Amount | 379446.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 6058 |
| Number Of Medicare Beneficiaries With Medical Services | 826 |
| Total Medical Submitted Charge Amount | 693168 |
| Total Medical Medicare Allowed Amount | 519695.29 |
| Total Medical Medicare Payment Amount | 404804.28 |
| Total Medical Medicare Standardized Payment Amount | 379446.67 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 323 |
| Number Of Female Beneficiaries | 483 |
| Number Of Male Beneficiaries | 343 |
| Number Of Non Hispanic White Beneficiaries | 602 |
| Number Of Black or African American Beneficiaries | 125 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 61 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 302 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 524 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 70 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 60 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 57 |
| Percent Of With Diabetes | 60 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 3.4981 |