| National Provider Identifier [NPI]: | 1174773113 |
| Last Name Of The Provider | BHATIA |
| First Name Of The Provider | SHAILENDER |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2800 W 95TH ST |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | EVERGREEN PARK |
| Zip Code Of The Provider | 608052701 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 175 |
| Number Of Services | 4736 |
| Number Of Medicare Beneficiaries | 1773 |
| Total Submitted Charge Amount | 481747.2 |
| Total Medicare Allowed Amount | 101066.24 |
| Total Medicare Payment Amount | 78537.22 |
| Total Medicare Standardized Payment Amount | 73458.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2085 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 2197.2 |
| Total Drug Medicare AllowedAmount | 569.25 |
| Total Drug Medicare PaymentAmount | 446.31 |
| Total Drug Medicare Standardized Payment Amount | 446.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 173 |
| Number Of Medical Services | 2651 |
| Number Of Medicare Beneficiaries With Medical Services | 1773 |
| Total Medical Submitted Charge Amount | 479550 |
| Total Medical Medicare Allowed Amount | 100496.99 |
| Total Medical Medicare Payment Amount | 78090.91 |
| Total Medical Medicare Standardized Payment Amount | 73011.72 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 298 |
| Number Of Beneficiaries Age 65 to 74 | 561 |
| Number Of Beneficiaries Age 75 to 84 | 567 |
| Number Of Beneficiaries Age Greater 84 | 347 |
| Number Of Female Beneficiaries | 1004 |
| Number Of Male Beneficiaries | 769 |
| Number Of Non Hispanic White Beneficiaries | 856 |
| Number Of Black or African American Beneficiaries | 242 |
| Number Of AsianPacific Islander Beneficiaries | 249 |
| Number Of Hispanic Beneficiaries | 378 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 679 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1094 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.536 |