| National Provider Identifier [NPI]: | 1821149238 |
| Last Name Of The Provider | GANDHI |
| First Name Of The Provider | SANJAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 351 GREENLEAF AVE STE E |
| Street Address 2 Of The Provider | |
| City Of The Provider | PARK CITY |
| Zip Code Of The Provider | 600855701 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 7364 |
| Number Of Medicare Beneficiaries | 516 |
| Total Submitted Charge Amount | 3005408.73 |
| Total Medicare Allowed Amount | 635491.8 |
| Total Medicare Payment Amount | 485922.31 |
| Total Medicare Standardized Payment Amount | 450405.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1301 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 87000 |
| Total Drug Medicare AllowedAmount | 7167.73 |
| Total Drug Medicare PaymentAmount | 5619.47 |
| Total Drug Medicare Standardized Payment Amount | 5619.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 6063 |
| Number Of Medicare Beneficiaries With Medical Services | 516 |
| Total Medical Submitted Charge Amount | 2918408.73 |
| Total Medical Medicare Allowed Amount | 628324.07 |
| Total Medical Medicare Payment Amount | 480302.84 |
| Total Medical Medicare Standardized Payment Amount | 444786.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 222 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 516 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 457 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 440 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0093 |