| National Provider Identifier [NPI]: | 1841293461 |
| Last Name Of The Provider | MEHTA |
| First Name Of The Provider | VIKRAM |
| 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 | 303 S NAPPANEE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELKHART |
| Zip Code Of The Provider | 465142066 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 7244 |
| Number Of Medicare Beneficiaries | 240 |
| Total Submitted Charge Amount | 319373.2 |
| Total Medicare Allowed Amount | 148978.29 |
| Total Medicare Payment Amount | 115281.68 |
| Total Medicare Standardized Payment Amount | 122724.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 23 |
| Number Of Drug Services | 3884 |
| Number Of Medicare Beneficiaries With Drug Services | 126 |
| Total Drug Submitted ChargeAmount | 24160.2 |
| Total Drug Medicare AllowedAmount | 10627.29 |
| Total Drug Medicare PaymentAmount | 8758.06 |
| Total Drug Medicare Standardized Payment Amount | 8758.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 3360 |
| Number Of Medicare Beneficiaries With Medical Services | 240 |
| Total Medical Submitted Charge Amount | 295213 |
| Total Medical Medicare Allowed Amount | 138351 |
| Total Medical Medicare Payment Amount | 106523.62 |
| Total Medical Medicare Standardized Payment Amount | 113966.37 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 212 |
| Number Of Black or African American Beneficiaries | |
| 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 | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2654 |