| National Provider Identifier [NPI]: | 1831170083 |
| Last Name Of The Provider | PATHAK |
| First Name Of The Provider | SANJAY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1606 N 7TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | TERRE HAUTE |
| Zip Code Of The Provider | 478042706 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 186 |
| Number Of Services | 3422 |
| Number Of Medicare Beneficiaries | 1955 |
| Total Submitted Charge Amount | 698598 |
| Total Medicare Allowed Amount | 178299.25 |
| Total Medicare Payment Amount | 137694.48 |
| Total Medicare Standardized Payment Amount | 145841.5 |
| 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 | 186 |
| Number Of Medical Services | 3422 |
| Number Of Medicare Beneficiaries With Medical Services | 1955 |
| Total Medical Submitted Charge Amount | 698598 |
| Total Medical Medicare Allowed Amount | 178299.25 |
| Total Medical Medicare Payment Amount | 137694.48 |
| Total Medical Medicare Standardized Payment Amount | 145841.5 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 444 |
| Number Of Beneficiaries Age 65 to 74 | 739 |
| Number Of Beneficiaries Age 75 to 84 | 494 |
| Number Of Beneficiaries Age Greater 84 | 278 |
| Number Of Female Beneficiaries | 1207 |
| Number Of Male Beneficiaries | 748 |
| Number Of Non Hispanic White Beneficiaries | 1881 |
| Number Of Black or African American Beneficiaries | 43 |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1346 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 609 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8366 |