| National Provider Identifier [NPI]: | 1679532279 |
| Last Name Of The Provider | SANDHU |
| First Name Of The Provider | MAHESH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3402 BATTLEGROUND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENSBORO |
| Zip Code Of The Provider | 274102404 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 753 |
| Number Of Medicare Beneficiaries | 360 |
| Total Submitted Charge Amount | 91613.53 |
| Total Medicare Allowed Amount | 38456.51 |
| Total Medicare Payment Amount | 29063.81 |
| Total Medicare Standardized Payment Amount | 30713.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 256 |
| Number Of Medicare Beneficiaries With Drug Services | 110 |
| Total Drug Submitted ChargeAmount | 3958 |
| Total Drug Medicare AllowedAmount | 1433.93 |
| Total Drug Medicare PaymentAmount | 1318.82 |
| Total Drug Medicare Standardized Payment Amount | 1318.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 497 |
| Number Of Medicare Beneficiaries With Medical Services | 300 |
| Total Medical Submitted Charge Amount | 87655.53 |
| Total Medical Medicare Allowed Amount | 37022.58 |
| Total Medical Medicare Payment Amount | 27744.99 |
| Total Medical Medicare Standardized Payment Amount | 29394.2 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 99 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 215 |
| Number Of Male Beneficiaries | 145 |
| Number Of Non Hispanic White Beneficiaries | 329 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 277 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.1987 |