| National Provider Identifier [NPI]: | 1508854787 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | GIRISH |
| 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 | 13634 NORTH 93RD AVENUE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 85381 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 5122 |
| Number Of Medicare Beneficiaries | 845 |
| Total Submitted Charge Amount | 605915 |
| Total Medicare Allowed Amount | 373644.1 |
| Total Medicare Payment Amount | 287769.32 |
| Total Medicare Standardized Payment Amount | 289865.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 815 |
| Number Of Medicare Beneficiaries With Drug Services | 176 |
| Total Drug Submitted ChargeAmount | 20656 |
| Total Drug Medicare AllowedAmount | 12347.72 |
| Total Drug Medicare PaymentAmount | 11823.2 |
| Total Drug Medicare Standardized Payment Amount | 11823.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 4307 |
| Number Of Medicare Beneficiaries With Medical Services | 845 |
| Total Medical Submitted Charge Amount | 585259 |
| Total Medical Medicare Allowed Amount | 361296.38 |
| Total Medical Medicare Payment Amount | 275946.12 |
| Total Medical Medicare Standardized Payment Amount | 278042.45 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 272 |
| Number Of Beneficiaries Age 75 to 84 | 317 |
| Number Of Beneficiaries Age Greater 84 | 218 |
| Number Of Female Beneficiaries | 432 |
| Number Of Male Beneficiaries | 413 |
| Number Of Non Hispanic White Beneficiaries | 789 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 789 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 29 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 61 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0632 |