| National Provider Identifier [NPI]: | 1659406510 |
| Last Name Of The Provider | WADHWANI |
| First Name Of The Provider | SURESH |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. S.C. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 455 W COURT ST STE 302 |
| Street Address 2 Of The Provider | |
| City Of The Provider | KANKAKEE |
| Zip Code Of The Provider | 609013694 |
| 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 | 79 |
| Number Of Services | 7185 |
| Number Of Medicare Beneficiaries | 1893 |
| Total Submitted Charge Amount | 1043864 |
| Total Medicare Allowed Amount | 615974.86 |
| Total Medicare Payment Amount | 465970.05 |
| Total Medicare Standardized Payment Amount | 469277.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 456 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 38428 |
| Total Drug Medicare AllowedAmount | 23929.13 |
| Total Drug Medicare PaymentAmount | 18641.67 |
| Total Drug Medicare Standardized Payment Amount | 18641.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 6729 |
| Number Of Medicare Beneficiaries With Medical Services | 1893 |
| Total Medical Submitted Charge Amount | 1005436 |
| Total Medical Medicare Allowed Amount | 592045.73 |
| Total Medical Medicare Payment Amount | 447328.38 |
| Total Medical Medicare Standardized Payment Amount | 450636.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 363 |
| Number Of Beneficiaries Age 65 to 74 | 621 |
| Number Of Beneficiaries Age 75 to 84 | 564 |
| Number Of Beneficiaries Age Greater 84 | 345 |
| Number Of Female Beneficiaries | 964 |
| Number Of Male Beneficiaries | 929 |
| Number Of Non Hispanic White Beneficiaries | 1577 |
| Number Of Black or African American Beneficiaries | 262 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1295 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 598 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.939 |