| National Provider Identifier [NPI]: | 1982606604 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | PRABODH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1324 WOODLAND DRIVE, |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ELIZABETHTOWN |
| Zip Code Of The Provider | 427012746 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 9229 |
| Number Of Medicare Beneficiaries | 2281 |
| Total Submitted Charge Amount | 1259276 |
| Total Medicare Allowed Amount | 550171.29 |
| Total Medicare Payment Amount | 404452.4 |
| Total Medicare Standardized Payment Amount | 429049.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 422 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 25500 |
| Total Drug Medicare AllowedAmount | 22242.55 |
| Total Drug Medicare PaymentAmount | 17401.99 |
| Total Drug Medicare Standardized Payment Amount | 17401.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 8807 |
| Number Of Medicare Beneficiaries With Medical Services | 2280 |
| Total Medical Submitted Charge Amount | 1233776 |
| Total Medical Medicare Allowed Amount | 527928.74 |
| Total Medical Medicare Payment Amount | 387050.41 |
| Total Medical Medicare Standardized Payment Amount | 411647.84 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 322 |
| Number Of Beneficiaries Age 65 to 74 | 822 |
| Number Of Beneficiaries Age 75 to 84 | 799 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 1206 |
| Number Of Male Beneficiaries | 1075 |
| Number Of Non Hispanic White Beneficiaries | 2114 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1812 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 469 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5604 |