| National Provider Identifier [NPI]: | 1902004401 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | SONIA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4060 BUTLER PIKE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | PLYMOUTH MEETING |
| Zip Code Of The Provider | 194621560 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 9566 |
| Number Of Medicare Beneficiaries | 1031 |
| Total Submitted Charge Amount | 5719509.63 |
| Total Medicare Allowed Amount | 2244803.5 |
| Total Medicare Payment Amount | 1739626.15 |
| Total Medicare Standardized Payment Amount | 1727778.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 3943 |
| Number Of Medicare Beneficiaries With Drug Services | 236 |
| Total Drug Submitted ChargeAmount | 3754401 |
| Total Drug Medicare AllowedAmount | 1616822.5 |
| Total Drug Medicare PaymentAmount | 1266030.38 |
| Total Drug Medicare Standardized Payment Amount | 1266030.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 5623 |
| Number Of Medicare Beneficiaries With Medical Services | 1031 |
| Total Medical Submitted Charge Amount | 1965108.63 |
| Total Medical Medicare Allowed Amount | 627981 |
| Total Medical Medicare Payment Amount | 473595.77 |
| Total Medical Medicare Standardized Payment Amount | 461748.16 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 331 |
| Number Of Beneficiaries Age Greater 84 | 220 |
| Number Of Female Beneficiaries | 619 |
| Number Of Male Beneficiaries | 412 |
| Number Of Non Hispanic White Beneficiaries | 846 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 856 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.394 |