| National Provider Identifier [NPI]: | 1699768432 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | GAUTAM |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4950 W 95TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OAK LAWN |
| Zip Code Of The Provider | 604532504 |
| 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 | 65 |
| Number Of Services | 3296 |
| Number Of Medicare Beneficiaries | 1157 |
| Total Submitted Charge Amount | 812506.87 |
| Total Medicare Allowed Amount | 355221.96 |
| Total Medicare Payment Amount | 273278.06 |
| Total Medicare Standardized Payment Amount | 254600.47 |
| 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 | 65 |
| Number Of Medical Services | 3296 |
| Number Of Medicare Beneficiaries With Medical Services | 1157 |
| Total Medical Submitted Charge Amount | 812506.87 |
| Total Medical Medicare Allowed Amount | 355221.96 |
| Total Medical Medicare Payment Amount | 273278.06 |
| Total Medical Medicare Standardized Payment Amount | 254600.47 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 377 |
| Number Of Beneficiaries Age 75 to 84 | 404 |
| Number Of Beneficiaries Age Greater 84 | 218 |
| Number Of Female Beneficiaries | 639 |
| Number Of Male Beneficiaries | 518 |
| Number Of Non Hispanic White Beneficiaries | 746 |
| Number Of Black or African American Beneficiaries | 316 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 844 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 313 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.4146 |