| National Provider Identifier [NPI]: | 1205822749 |
| Last Name Of The Provider | PODUVAL |
| First Name Of The Provider | RAJIV |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 337 E CORONADO RD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850041580 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 2298 |
| Number Of Medicare Beneficiaries | 543 |
| Total Submitted Charge Amount | 396358 |
| Total Medicare Allowed Amount | 194053.06 |
| Total Medicare Payment Amount | 141896.93 |
| Total Medicare Standardized Payment Amount | 149735.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 446 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 10258 |
| Total Drug Medicare AllowedAmount | 5155.22 |
| Total Drug Medicare PaymentAmount | 4041.68 |
| Total Drug Medicare Standardized Payment Amount | 4041.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1852 |
| Number Of Medicare Beneficiaries With Medical Services | 543 |
| Total Medical Submitted Charge Amount | 386100 |
| Total Medical Medicare Allowed Amount | 188897.84 |
| Total Medical Medicare Payment Amount | 137855.25 |
| Total Medical Medicare Standardized Payment Amount | 145693.51 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 237 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 232 |
| Number Of Male Beneficiaries | 311 |
| Number Of Non Hispanic White Beneficiaries | 304 |
| Number Of Black or African American Beneficiaries | 52 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 109 |
| Number Of American Indian Alaska Native Beneficiaries | 56 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 374 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 169 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 3.8273 |