| National Provider Identifier [NPI]: | 1508823998 |
| Last Name Of The Provider | SAMPAT |
| First Name Of The Provider | PARAG |
| 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 | 2137 OAK PARK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BERWYN |
| Zip Code Of The Provider | 604021718 |
| 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 | 60 |
| Number Of Services | 6030 |
| Number Of Medicare Beneficiaries | 1460 |
| Total Submitted Charge Amount | 516733 |
| Total Medicare Allowed Amount | 251594.79 |
| Total Medicare Payment Amount | 186309.35 |
| Total Medicare Standardized Payment Amount | 200408.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 479 |
| Number Of Medicare Beneficiaries With Drug Services | 325 |
| Total Drug Submitted ChargeAmount | 18542 |
| Total Drug Medicare AllowedAmount | 13132.1 |
| Total Drug Medicare PaymentAmount | 12770.01 |
| Total Drug Medicare Standardized Payment Amount | 12770.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 5551 |
| Number Of Medicare Beneficiaries With Medical Services | 1459 |
| Total Medical Submitted Charge Amount | 498191 |
| Total Medical Medicare Allowed Amount | 238462.69 |
| Total Medical Medicare Payment Amount | 173539.34 |
| Total Medical Medicare Standardized Payment Amount | 187638.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 167 |
| Number Of Beneficiaries Age 65 to 74 | 501 |
| Number Of Beneficiaries Age 75 to 84 | 500 |
| Number Of Beneficiaries Age Greater 84 | 292 |
| Number Of Female Beneficiaries | 742 |
| Number Of Male Beneficiaries | 718 |
| Number Of Non Hispanic White Beneficiaries | 1310 |
| Number Of Black or African American Beneficiaries | 130 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 241 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5898 |