| National Provider Identifier [NPI]: | 1073552261 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | SAMIR |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5298 SOCIALVILLE FOSTER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MASON |
| Zip Code Of The Provider | 450409302 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 10730 |
| Number Of Medicare Beneficiaries | 2971 |
| Total Submitted Charge Amount | 1540446 |
| Total Medicare Allowed Amount | 716763.33 |
| Total Medicare Payment Amount | 538029.21 |
| Total Medicare Standardized Payment Amount | 437260.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 79 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 26191 |
| Total Drug Medicare AllowedAmount | 19148.27 |
| Total Drug Medicare PaymentAmount | 13888.51 |
| Total Drug Medicare Standardized Payment Amount | 13888.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 10651 |
| Number Of Medicare Beneficiaries With Medical Services | 2971 |
| Total Medical Submitted Charge Amount | 1514255 |
| Total Medical Medicare Allowed Amount | 697615.06 |
| Total Medical Medicare Payment Amount | 524140.7 |
| Total Medical Medicare Standardized Payment Amount | 423372.1 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 1403 |
| Number Of Beneficiaries Age 75 to 84 | 1047 |
| Number Of Beneficiaries Age Greater 84 | 442 |
| Number Of Female Beneficiaries | 1482 |
| Number Of Male Beneficiaries | 1489 |
| Number Of Non Hispanic White Beneficiaries | 2858 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2902 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9806 |