| National Provider Identifier [NPI]: | 1831226042 |
| Last Name Of The Provider | GANDHI |
| First Name Of The Provider | SIDDHARTH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1302 FRANKLIN AVE |
| Street Address 2 Of The Provider | SUITE 4500 |
| City Of The Provider | NORMAL |
| Zip Code Of The Provider | 617613551 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 3432 |
| Number Of Medicare Beneficiaries | 1540 |
| Total Submitted Charge Amount | 785554 |
| Total Medicare Allowed Amount | 270522.2 |
| Total Medicare Payment Amount | 207548.33 |
| Total Medicare Standardized Payment Amount | 211989.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 149 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 12140 |
| Total Drug Medicare AllowedAmount | 7914.43 |
| Total Drug Medicare PaymentAmount | 6097.21 |
| Total Drug Medicare Standardized Payment Amount | 6097.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 116 |
| Number Of Medical Services | 3283 |
| Number Of Medicare Beneficiaries With Medical Services | 1540 |
| Total Medical Submitted Charge Amount | 773414 |
| Total Medical Medicare Allowed Amount | 262607.77 |
| Total Medical Medicare Payment Amount | 201451.12 |
| Total Medical Medicare Standardized Payment Amount | 205892.6 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 562 |
| Number Of Beneficiaries Age 75 to 84 | 499 |
| Number Of Beneficiaries Age Greater 84 | 283 |
| Number Of Female Beneficiaries | 798 |
| Number Of Male Beneficiaries | 742 |
| Number Of Non Hispanic White Beneficiaries | 1437 |
| Number Of Black or African American Beneficiaries | 61 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1246 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 294 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5324 |