| National Provider Identifier [NPI]: | 1104001122 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | ANKITKUMAR |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 311 CAMDEN ST |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782152012 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 14613 |
| Number Of Medicare Beneficiaries | 3121 |
| Total Submitted Charge Amount | 1558641.22 |
| Total Medicare Allowed Amount | 406536.61 |
| Total Medicare Payment Amount | 299503.78 |
| Total Medicare Standardized Payment Amount | 328798.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 9895 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 12380.65 |
| Total Drug Medicare AllowedAmount | 3375.29 |
| Total Drug Medicare PaymentAmount | 2403.2 |
| Total Drug Medicare Standardized Payment Amount | 2403.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 4718 |
| Number Of Medicare Beneficiaries With Medical Services | 3121 |
| Total Medical Submitted Charge Amount | 1546260.57 |
| Total Medical Medicare Allowed Amount | 403161.32 |
| Total Medical Medicare Payment Amount | 297100.58 |
| Total Medical Medicare Standardized Payment Amount | 326395.27 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 747 |
| Number Of Beneficiaries Age 65 to 74 | 1227 |
| Number Of Beneficiaries Age 75 to 84 | 746 |
| Number Of Beneficiaries Age Greater 84 | 401 |
| Number Of Female Beneficiaries | 1919 |
| Number Of Male Beneficiaries | 1202 |
| Number Of Non Hispanic White Beneficiaries | 1466 |
| Number Of Black or African American Beneficiaries | 290 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 1302 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2094 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1027 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0851 |