| National Provider Identifier [NPI]: | 1811951197 |
| Last Name Of The Provider | VASAVADA |
| First Name Of The Provider | RAJIV |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2320 HIGH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLUE ISLAND |
| Zip Code Of The Provider | 604062426 |
| 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 | 151 |
| Number Of Services | 7840 |
| Number Of Medicare Beneficiaries | 589 |
| Total Submitted Charge Amount | 594682 |
| Total Medicare Allowed Amount | 280182.07 |
| Total Medicare Payment Amount | 203419.98 |
| Total Medicare Standardized Payment Amount | 192649.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 918 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 8129 |
| Total Drug Medicare AllowedAmount | 3739.03 |
| Total Drug Medicare PaymentAmount | 3510.72 |
| Total Drug Medicare Standardized Payment Amount | 3510.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 6922 |
| Number Of Medicare Beneficiaries With Medical Services | 589 |
| Total Medical Submitted Charge Amount | 586553 |
| Total Medical Medicare Allowed Amount | 276443.04 |
| Total Medical Medicare Payment Amount | 199909.26 |
| Total Medical Medicare Standardized Payment Amount | 189139.1 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 285 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 274 |
| Number Of Non Hispanic White Beneficiaries | 330 |
| Number Of Black or African American Beneficiaries | 174 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 505 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.184 |