| National Provider Identifier [NPI]: | 1538127196 |
| Last Name Of The Provider | KHATTI |
| First Name Of The Provider | SANJAY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3500 EAST I-30 |
| Street Address 2 Of The Provider | |
| City Of The Provider | MESQUITE |
| Zip Code Of The Provider | 75150 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 4691 |
| Number Of Medicare Beneficiaries | 2616 |
| Total Submitted Charge Amount | 527611.64 |
| Total Medicare Allowed Amount | 143996.85 |
| Total Medicare Payment Amount | 111635.05 |
| Total Medicare Standardized Payment Amount | 113160.63 |
| 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 | 169 |
| Number Of Medical Services | 4691 |
| Number Of Medicare Beneficiaries With Medical Services | 2616 |
| Total Medical Submitted Charge Amount | 527611.64 |
| Total Medical Medicare Allowed Amount | 143996.85 |
| Total Medical Medicare Payment Amount | 111635.05 |
| Total Medical Medicare Standardized Payment Amount | 113160.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 412 |
| Number Of Beneficiaries Age 65 to 74 | 966 |
| Number Of Beneficiaries Age 75 to 84 | 788 |
| Number Of Beneficiaries Age Greater 84 | 450 |
| Number Of Female Beneficiaries | 1663 |
| Number Of Male Beneficiaries | 953 |
| Number Of Non Hispanic White Beneficiaries | 1790 |
| Number Of Black or African American Beneficiaries | 331 |
| Number Of AsianPacific Islander Beneficiaries | 240 |
| 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 | 1828 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 788 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8564 |