| National Provider Identifier [NPI]: | 1902012099 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | PANKAJ |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1601 WATSON BLVD |
| Street Address 2 Of The Provider | ATTN RADIOLOGY DEPT |
| City Of The Provider | WARNER ROBINS |
| Zip Code Of The Provider | 310933431 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 136 |
| Number Of Services | 3687 |
| Number Of Medicare Beneficiaries | 2483 |
| Total Submitted Charge Amount | 813408.75 |
| Total Medicare Allowed Amount | 142744.68 |
| Total Medicare Payment Amount | 108792.61 |
| Total Medicare Standardized Payment Amount | 114964.01 |
| 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 | 136 |
| Number Of Medical Services | 3687 |
| Number Of Medicare Beneficiaries With Medical Services | 2483 |
| Total Medical Submitted Charge Amount | 813408.75 |
| Total Medical Medicare Allowed Amount | 142744.68 |
| Total Medical Medicare Payment Amount | 108792.61 |
| Total Medical Medicare Standardized Payment Amount | 114964.01 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 702 |
| Number Of Beneficiaries Age 65 to 74 | 849 |
| Number Of Beneficiaries Age 75 to 84 | 645 |
| Number Of Beneficiaries Age Greater 84 | 287 |
| Number Of Female Beneficiaries | 1469 |
| Number Of Male Beneficiaries | 1014 |
| Number Of Non Hispanic White Beneficiaries | 1232 |
| Number Of Black or African American Beneficiaries | 1113 |
| Number Of AsianPacific Islander Beneficiaries | 59 |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1595 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 888 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9832 |