| National Provider Identifier [NPI]: | 1821137563 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | DIVYESH |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 825 E LINCOLNWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | VALPARAISO |
| Zip Code Of The Provider | 463835803 |
| 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 | 198 |
| Number Of Services | 5836 |
| Number Of Medicare Beneficiaries | 3434 |
| Total Submitted Charge Amount | 713042 |
| Total Medicare Allowed Amount | 175938.6 |
| Total Medicare Payment Amount | 130584.53 |
| Total Medicare Standardized Payment Amount | 137732.2 |
| 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 | 198 |
| Number Of Medical Services | 5836 |
| Number Of Medicare Beneficiaries With Medical Services | 3434 |
| Total Medical Submitted Charge Amount | 713042 |
| Total Medical Medicare Allowed Amount | 175938.6 |
| Total Medical Medicare Payment Amount | 130584.53 |
| Total Medical Medicare Standardized Payment Amount | 137732.2 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 590 |
| Number Of Beneficiaries Age 65 to 74 | 1307 |
| Number Of Beneficiaries Age 75 to 84 | 998 |
| Number Of Beneficiaries Age Greater 84 | 539 |
| Number Of Female Beneficiaries | 2115 |
| Number Of Male Beneficiaries | 1319 |
| Number Of Non Hispanic White Beneficiaries | 3178 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 110 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2704 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 730 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6266 |