| National Provider Identifier [NPI]: | 1417994013 |
| Last Name Of The Provider | GANDHI |
| First Name Of The Provider | BHAVESH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16151 WEBER ROAD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | CREST HILL |
| Zip Code Of The Provider | 604030000 |
| 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 | 57 |
| Number Of Services | 8258 |
| Number Of Medicare Beneficiaries | 996 |
| Total Submitted Charge Amount | 1387671.12 |
| Total Medicare Allowed Amount | 731720.94 |
| Total Medicare Payment Amount | 546621.93 |
| Total Medicare Standardized Payment Amount | 520725.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 253 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 3542.5 |
| Total Drug Medicare AllowedAmount | 1469.58 |
| Total Drug Medicare PaymentAmount | 1362.6 |
| Total Drug Medicare Standardized Payment Amount | 1362.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 8005 |
| Number Of Medicare Beneficiaries With Medical Services | 996 |
| Total Medical Submitted Charge Amount | 1384128.62 |
| Total Medical Medicare Allowed Amount | 730251.36 |
| Total Medical Medicare Payment Amount | 545259.33 |
| Total Medical Medicare Standardized Payment Amount | 519363.01 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 230 |
| Number Of Beneficiaries Age 75 to 84 | 373 |
| Number Of Beneficiaries Age Greater 84 | 380 |
| Number Of Female Beneficiaries | 674 |
| Number Of Male Beneficiaries | 322 |
| Number Of Non Hispanic White Beneficiaries | 903 |
| Number Of Black or African American Beneficiaries | 51 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 876 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 120 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 40 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5655 |