| National Provider Identifier [NPI]: | 1114910528 |
| Last Name Of The Provider | PATEL |
| First Name Of The Provider | KETAN |
| 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 | 530 PARK AVE E |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | PRINCETON |
| Zip Code Of The Provider | 613563901 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 5077 |
| Number Of Medicare Beneficiaries | 1402 |
| Total Submitted Charge Amount | 554298.48 |
| Total Medicare Allowed Amount | 244594.04 |
| Total Medicare Payment Amount | 163897.74 |
| Total Medicare Standardized Payment Amount | 169735.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 261 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 4290.48 |
| Total Drug Medicare AllowedAmount | 2430.06 |
| Total Drug Medicare PaymentAmount | 2065.92 |
| Total Drug Medicare Standardized Payment Amount | 2065.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 4816 |
| Number Of Medicare Beneficiaries With Medical Services | 1402 |
| Total Medical Submitted Charge Amount | 550008 |
| Total Medical Medicare Allowed Amount | 242163.98 |
| Total Medical Medicare Payment Amount | 161831.82 |
| Total Medical Medicare Standardized Payment Amount | 167669.96 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 491 |
| Number Of Beneficiaries Age 75 to 84 | 428 |
| Number Of Beneficiaries Age Greater 84 | 346 |
| Number Of Female Beneficiaries | 791 |
| Number Of Male Beneficiaries | 611 |
| Number Of Non Hispanic White Beneficiaries | 1359 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 256 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2183 |