| National Provider Identifier [NPI]: | 1023049764 |
| Last Name Of The Provider | TAKHTANI |
| First Name Of The Provider | DEEPAK |
| 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 | UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL |
| Street Address 2 Of The Provider | RADIOLOGY, UNIVERSTIY CAMPUS, 55 LAKE AVE NORTH |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 01655 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 1617 |
| Number Of Medicare Beneficiaries | 1100 |
| Total Submitted Charge Amount | 532323 |
| Total Medicare Allowed Amount | 105127.11 |
| Total Medicare Payment Amount | 80870.27 |
| Total Medicare Standardized Payment Amount | 81579.83 |
| 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 | 43 |
| Number Of Medical Services | 1617 |
| Number Of Medicare Beneficiaries With Medical Services | 1100 |
| Total Medical Submitted Charge Amount | 532323 |
| Total Medical Medicare Allowed Amount | 105127.11 |
| Total Medical Medicare Payment Amount | 80870.27 |
| Total Medical Medicare Standardized Payment Amount | 81579.83 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 316 |
| Number Of Beneficiaries Age 65 to 74 | 343 |
| Number Of Beneficiaries Age 75 to 84 | 244 |
| Number Of Beneficiaries Age Greater 84 | 197 |
| Number Of Female Beneficiaries | 600 |
| Number Of Male Beneficiaries | 500 |
| Number Of Non Hispanic White Beneficiaries | 956 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 651 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 449 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 1.7527 |