| National Provider Identifier [NPI]: | 1811970486 |
| Last Name Of The Provider | BANSAL |
| First Name Of The Provider | PRIYA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D., |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 303 E ARMY TRAIL RD |
| Street Address 2 Of The Provider | STE#403 |
| City Of The Provider | BLOOMINGDALE |
| Zip Code Of The Provider | 601082169 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2361 |
| Number Of Medicare Beneficiaries | 132 |
| Total Submitted Charge Amount | 81739 |
| Total Medicare Allowed Amount | 39780.96 |
| Total Medicare Payment Amount | 29756.51 |
| Total Medicare Standardized Payment Amount | 28154.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 1439 |
| Total Drug Medicare AllowedAmount | 249.36 |
| Total Drug Medicare PaymentAmount | 226.54 |
| Total Drug Medicare Standardized Payment Amount | 226.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 2309 |
| Number Of Medicare Beneficiaries With Medical Services | 132 |
| Total Medical Submitted Charge Amount | 80300 |
| Total Medical Medicare Allowed Amount | 39531.6 |
| Total Medical Medicare Payment Amount | 29529.97 |
| Total Medical Medicare Standardized Payment Amount | 27927.95 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 98 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 115 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 121 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 36 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8228 |