National Provider Identifier [NPI]: |
1033432109 |
Last Name Of The Provider |
AGARWAL |
First Name Of The Provider |
GAURAV |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1901 W HARRISON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123714 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
16 |
Number Of Services |
754 |
Number Of Medicare Beneficiaries |
349 |
Total Submitted Charge Amount |
162912 |
Total Medicare Allowed Amount |
86524.58 |
Total Medicare Payment Amount |
66048.98 |
Total Medicare Standardized Payment Amount |
61512.07 |
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 |
16 |
Number Of Medical Services |
754 |
Number Of Medicare Beneficiaries With Medical Services |
349 |
Total Medical Submitted Charge Amount |
162912 |
Total Medical Medicare Allowed Amount |
86524.58 |
Total Medical Medicare Payment Amount |
66048.98 |
Total Medical Medicare Standardized Payment Amount |
61512.07 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
119 |
Number Of Beneficiaries Age 65 to 74 |
94 |
Number Of Beneficiaries Age 75 to 84 |
96 |
Number Of Beneficiaries Age Greater 84 |
40 |
Number Of Female Beneficiaries |
185 |
Number Of Male Beneficiaries |
164 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
259 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
67 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
282 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
34 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
66 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
68 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
65 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
24 |
Average HCC Risk Score Of Beneficiaries |
3.0825 |