| National Provider Identifier [NPI]: | 1093731895 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | VIPIN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 E WOODROW WILSON AVE |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY, V A HOSPITAL |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392165116 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 72934 |
| Number Of Medicare Beneficiaries | 547 |
| Total Submitted Charge Amount | 5883383 |
| Total Medicare Allowed Amount | 1944960.88 |
| Total Medicare Payment Amount | 1509081.71 |
| Total Medicare Standardized Payment Amount | 1734989.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 69795 |
| Number Of Medicare Beneficiaries With Drug Services | 449 |
| Total Drug Submitted ChargeAmount | 86130 |
| Total Drug Medicare AllowedAmount | 25249.8 |
| Total Drug Medicare PaymentAmount | 19647.21 |
| Total Drug Medicare Standardized Payment Amount | 19647.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 3139 |
| Number Of Medicare Beneficiaries With Medical Services | 547 |
| Total Medical Submitted Charge Amount | 5797253 |
| Total Medical Medicare Allowed Amount | 1919711.08 |
| Total Medical Medicare Payment Amount | 1489434.5 |
| Total Medical Medicare Standardized Payment Amount | 1715342.09 |
| Average Age Of Beneficiaries | 60 |
| Number Of Beneficiaries Age Less65 | 318 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 286 |
| Number Of Male Beneficiaries | 261 |
| Number Of Non Hispanic White Beneficiaries | 106 |
| Number Of Black or African American Beneficiaries | 428 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 200 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 347 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 7.6214 |