| National Provider Identifier [NPI]: | 1477654630 |
| Last Name Of The Provider | BANSAL |
| First Name Of The Provider | SHARAD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 S NATIONAL AVE |
| Street Address 2 Of The Provider | SUITE 3600 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 658042265 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 4662 |
| Number Of Medicare Beneficiaries | 2628 |
| Total Submitted Charge Amount | 1109802 |
| Total Medicare Allowed Amount | 230749.84 |
| Total Medicare Payment Amount | 168690.97 |
| Total Medicare Standardized Payment Amount | 179523.15 |
| 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 | 52 |
| Number Of Medical Services | 4662 |
| Number Of Medicare Beneficiaries With Medical Services | 2628 |
| Total Medical Submitted Charge Amount | 1109802 |
| Total Medical Medicare Allowed Amount | 230749.84 |
| Total Medical Medicare Payment Amount | 168690.97 |
| Total Medical Medicare Standardized Payment Amount | 179523.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 410 |
| Number Of Beneficiaries Age 65 to 74 | 974 |
| Number Of Beneficiaries Age 75 to 84 | 856 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 1341 |
| Number Of Male Beneficiaries | 1287 |
| Number Of Non Hispanic White Beneficiaries | 2537 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2080 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 548 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.6126 |