National Provider Identifier [NPI]: |
1255373395 |
Last Name Of The Provider |
AGARWAL |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
714 N. SENATE AVE |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462023297 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
139 |
Number Of Services |
929 |
Number Of Medicare Beneficiaries |
258 |
Total Submitted Charge Amount |
1024405 |
Total Medicare Allowed Amount |
96375.57 |
Total Medicare Payment Amount |
74786.59 |
Total Medicare Standardized Payment Amount |
76579.26 |
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 |
139 |
Number Of Medical Services |
929 |
Number Of Medicare Beneficiaries With Medical Services |
258 |
Total Medical Submitted Charge Amount |
1024405 |
Total Medical Medicare Allowed Amount |
96375.57 |
Total Medical Medicare Payment Amount |
74786.59 |
Total Medical Medicare Standardized Payment Amount |
76579.26 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
75 |
Number Of Beneficiaries Age 75 to 84 |
41 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
169 |
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 |
129 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
67 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
52 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
4.3227 |