| National Provider Identifier [NPI]: | 1588786735 |
| Last Name Of The Provider | DAVE |
| First Name Of The Provider | VIVEK |
| 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 | 737 N MICHIGAN AVE |
| Street Address 2 Of The Provider | STE 1600 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606112615 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 5679 |
| Number Of Medicare Beneficiaries | 3601 |
| Total Submitted Charge Amount | 638019 |
| Total Medicare Allowed Amount | 228682.03 |
| Total Medicare Payment Amount | 174357.98 |
| Total Medicare Standardized Payment Amount | 168131.49 |
| 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 | 177 |
| Number Of Medical Services | 5679 |
| Number Of Medicare Beneficiaries With Medical Services | 3601 |
| Total Medical Submitted Charge Amount | 638019 |
| Total Medical Medicare Allowed Amount | 228682.03 |
| Total Medical Medicare Payment Amount | 174357.98 |
| Total Medical Medicare Standardized Payment Amount | 168131.49 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 357 |
| Number Of Beneficiaries Age 65 to 74 | 1227 |
| Number Of Beneficiaries Age 75 to 84 | 1150 |
| Number Of Beneficiaries Age Greater 84 | 867 |
| Number Of Female Beneficiaries | 2176 |
| Number Of Male Beneficiaries | 1425 |
| Number Of Non Hispanic White Beneficiaries | 2972 |
| Number Of Black or African American Beneficiaries | 251 |
| Number Of AsianPacific Islander Beneficiaries | 91 |
| Number Of Hispanic Beneficiaries | 235 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2977 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 624 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6614 |