National Provider Identifier [NPI]: |
1659348050 |
Last Name Of The Provider |
GREWAL |
First Name Of The Provider |
NAVRAJ |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8599 HAVEN AVE |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
RANCHO CUCAMONGA |
Zip Code Of The Provider |
917304849 |
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 |
166 |
Number Of Services |
3086 |
Number Of Medicare Beneficiaries |
2044 |
Total Submitted Charge Amount |
295293.6 |
Total Medicare Allowed Amount |
96282.46 |
Total Medicare Payment Amount |
73953.54 |
Total Medicare Standardized Payment Amount |
72985.09 |
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 |
166 |
Number Of Medical Services |
3086 |
Number Of Medicare Beneficiaries With Medical Services |
2044 |
Total Medical Submitted Charge Amount |
295293.6 |
Total Medical Medicare Allowed Amount |
96282.46 |
Total Medical Medicare Payment Amount |
73953.54 |
Total Medical Medicare Standardized Payment Amount |
72985.09 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
529 |
Number Of Beneficiaries Age 65 to 74 |
617 |
Number Of Beneficiaries Age 75 to 84 |
599 |
Number Of Beneficiaries Age Greater 84 |
299 |
Number Of Female Beneficiaries |
1117 |
Number Of Male Beneficiaries |
927 |
Number Of Non Hispanic White Beneficiaries |
862 |
Number Of Black or African American Beneficiaries |
297 |
Number Of AsianPacific Islander Beneficiaries |
126 |
Number Of Hispanic Beneficiaries |
723 |
Number Of American Indian Alaska Native Beneficiaries |
16 |
Number Of Beneficiaries With Race Not Else where Classified |
20 |
Number Of Beneficiaries With Medicare Only Entitlement |
672 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1372 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
55 |
Percent Of With Chronic Kidney Disease |
59 |
Percent Of With Chronic Obstructive Pulmonary Disease |
42 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
57 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.8551 |