National Provider Identifier [NPI]: |
1326091737 |
Last Name Of The Provider |
AGARWAL |
First Name Of The Provider |
JAY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
401 E HIGHLAND AVE |
Street Address 2 Of The Provider |
SUITE 551 |
City Of The Provider |
SAN BERNARDINO |
Zip Code Of The Provider |
924043803 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
2241 |
Number Of Medicare Beneficiaries |
475 |
Total Submitted Charge Amount |
582175.31 |
Total Medicare Allowed Amount |
255234.63 |
Total Medicare Payment Amount |
192805.05 |
Total Medicare Standardized Payment Amount |
187624.99 |
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 |
18 |
Number Of Medical Services |
2241 |
Number Of Medicare Beneficiaries With Medical Services |
475 |
Total Medical Submitted Charge Amount |
582175.31 |
Total Medical Medicare Allowed Amount |
255234.63 |
Total Medical Medicare Payment Amount |
192805.05 |
Total Medical Medicare Standardized Payment Amount |
187624.99 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
123 |
Number Of Beneficiaries Age 65 to 74 |
175 |
Number Of Beneficiaries Age 75 to 84 |
115 |
Number Of Beneficiaries Age Greater 84 |
62 |
Number Of Female Beneficiaries |
222 |
Number Of Male Beneficiaries |
253 |
Number Of Non Hispanic White Beneficiaries |
187 |
Number Of Black or African American Beneficiaries |
93 |
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
151 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
137 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
338 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
71 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
71 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
4.1896 |