| National Provider Identifier [NPI]: | 1467636753 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | BENA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1020 SANSOM ST |
| Street Address 2 Of The Provider | SUITE 239 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191075002 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 820 |
| Number Of Medicare Beneficiaries | 696 |
| Total Submitted Charge Amount | 780187 |
| Total Medicare Allowed Amount | 122765.61 |
| Total Medicare Payment Amount | 95987.32 |
| Total Medicare Standardized Payment Amount | 85643.73 |
| 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 | 20 |
| Number Of Medical Services | 820 |
| Number Of Medicare Beneficiaries With Medical Services | 696 |
| Total Medical Submitted Charge Amount | 780187 |
| Total Medical Medicare Allowed Amount | 122765.61 |
| Total Medical Medicare Payment Amount | 95987.32 |
| Total Medical Medicare Standardized Payment Amount | 85643.73 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 220 |
| Number Of Beneficiaries Age Greater 84 | 216 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 272 |
| Number Of Non Hispanic White Beneficiaries | 585 |
| Number Of Black or African American Beneficiaries | 57 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 516 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 30 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.2154 |