| National Provider Identifier [NPI]: | 1952562209 |
| Last Name Of The Provider | BAHL |
| First Name Of The Provider | GAUTAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1702 ESPLANADE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHICO |
| Zip Code Of The Provider | 959263315 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 259 |
| Number Of Services | 20013 |
| Number Of Medicare Beneficiaries | 5417 |
| Total Submitted Charge Amount | 1999913.5 |
| Total Medicare Allowed Amount | 629221.28 |
| Total Medicare Payment Amount | 484541.12 |
| Total Medicare Standardized Payment Amount | 474191.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 11566 |
| Number Of Medicare Beneficiaries With Drug Services | 258 |
| Total Drug Submitted ChargeAmount | 34760.5 |
| Total Drug Medicare AllowedAmount | 5946.58 |
| Total Drug Medicare PaymentAmount | 4634.62 |
| Total Drug Medicare Standardized Payment Amount | 4634.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 251 |
| Number Of Medical Services | 8447 |
| Number Of Medicare Beneficiaries With Medical Services | 5415 |
| Total Medical Submitted Charge Amount | 1965153 |
| Total Medical Medicare Allowed Amount | 623274.7 |
| Total Medical Medicare Payment Amount | 479906.5 |
| Total Medical Medicare Standardized Payment Amount | 469556.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1018 |
| Number Of Beneficiaries Age 65 to 74 | 1914 |
| Number Of Beneficiaries Age 75 to 84 | 1540 |
| Number Of Beneficiaries Age Greater 84 | 945 |
| Number Of Female Beneficiaries | 3114 |
| Number Of Male Beneficiaries | 2303 |
| Number Of Non Hispanic White Beneficiaries | 4859 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | 57 |
| Number Of Hispanic Beneficiaries | 339 |
| Number Of American Indian Alaska Native Beneficiaries | 67 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3816 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1601 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5395 |