| National Provider Identifier [NPI]: | 1417172768 |
| Last Name Of The Provider | MITHALAL |
| First Name Of The Provider | RAJESH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3400 N CENTER RD |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | SAGINAW |
| Zip Code Of The Provider | 486037920 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 10277 |
| Number Of Medicare Beneficiaries | 6205 |
| Total Submitted Charge Amount | 559172 |
| Total Medicare Allowed Amount | 282541.28 |
| Total Medicare Payment Amount | 214504.78 |
| Total Medicare Standardized Payment Amount | 223715.08 |
| 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 | 178 |
| Number Of Medical Services | 10277 |
| Number Of Medicare Beneficiaries With Medical Services | 6205 |
| Total Medical Submitted Charge Amount | 559172 |
| Total Medical Medicare Allowed Amount | 282541.28 |
| Total Medical Medicare Payment Amount | 214504.78 |
| Total Medical Medicare Standardized Payment Amount | 223715.08 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1473 |
| Number Of Beneficiaries Age 65 to 74 | 2119 |
| Number Of Beneficiaries Age 75 to 84 | 1706 |
| Number Of Beneficiaries Age Greater 84 | 907 |
| Number Of Female Beneficiaries | 3570 |
| Number Of Male Beneficiaries | 2635 |
| Number Of Non Hispanic White Beneficiaries | 5110 |
| Number Of Black or African American Beneficiaries | 822 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 192 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4402 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1803 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7194 |