| National Provider Identifier [NPI]: | 1487679205 |
| Last Name Of The Provider | HARYANI |
| First Name Of The Provider | VIJAY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD, FACC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 375 N WALL ST |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | KANKAKEE |
| Zip Code Of The Provider | 609013483 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 8547 |
| Number Of Medicare Beneficiaries | 2556 |
| Total Submitted Charge Amount | 2947387 |
| Total Medicare Allowed Amount | 744430.24 |
| Total Medicare Payment Amount | 557001.83 |
| Total Medicare Standardized Payment Amount | 575921.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 29 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 5320 |
| Total Drug Medicare AllowedAmount | 1224.75 |
| Total Drug Medicare PaymentAmount | 960.26 |
| Total Drug Medicare Standardized Payment Amount | 960.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 164 |
| Number Of Medical Services | 8518 |
| Number Of Medicare Beneficiaries With Medical Services | 2556 |
| Total Medical Submitted Charge Amount | 2942067 |
| Total Medical Medicare Allowed Amount | 743205.49 |
| Total Medical Medicare Payment Amount | 556041.57 |
| Total Medical Medicare Standardized Payment Amount | 574961.51 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 320 |
| Number Of Beneficiaries Age 65 to 74 | 881 |
| Number Of Beneficiaries Age 75 to 84 | 850 |
| Number Of Beneficiaries Age Greater 84 | 505 |
| Number Of Female Beneficiaries | 1294 |
| Number Of Male Beneficiaries | 1262 |
| Number Of Non Hispanic White Beneficiaries | 2293 |
| Number Of Black or African American Beneficiaries | 193 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2030 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 526 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6946 |