| National Provider Identifier [NPI]: | 1639128242 |
| Last Name Of The Provider | GARRIS |
| First Name Of The Provider | JOEL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12401 EAST WASHINGTON BLVD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | WHITTIER |
| Zip Code Of The Provider | 906021006 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 2310 |
| Number Of Medicare Beneficiaries | 1423 |
| Total Submitted Charge Amount | 480784.4 |
| Total Medicare Allowed Amount | 126890.25 |
| Total Medicare Payment Amount | 90088.1 |
| Total Medicare Standardized Payment Amount | 85714.8 |
| 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 | 152 |
| Number Of Medical Services | 2310 |
| Number Of Medicare Beneficiaries With Medical Services | 1423 |
| Total Medical Submitted Charge Amount | 480784.4 |
| Total Medical Medicare Allowed Amount | 126890.25 |
| Total Medical Medicare Payment Amount | 90088.1 |
| Total Medical Medicare Standardized Payment Amount | 85714.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 221 |
| Number Of Beneficiaries Age 65 to 74 | 433 |
| Number Of Beneficiaries Age 75 to 84 | 450 |
| Number Of Beneficiaries Age Greater 84 | 319 |
| Number Of Female Beneficiaries | 903 |
| Number Of Male Beneficiaries | 520 |
| Number Of Non Hispanic White Beneficiaries | 678 |
| Number Of Black or African American Beneficiaries | 30 |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 600 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 862 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 561 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.1169 |