| National Provider Identifier [NPI]: | 1376506121 |
| Last Name Of The Provider | DAHAL |
| First Name Of The Provider | SANJIV |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 PLEASANT STREET |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | DES MOINES |
| Zip Code Of The Provider | 503091409 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 3311 |
| Number Of Medicare Beneficiaries | 629 |
| Total Submitted Charge Amount | 406990 |
| Total Medicare Allowed Amount | 199162.04 |
| Total Medicare Payment Amount | 152800.07 |
| Total Medicare Standardized Payment Amount | 152849.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1337 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 18839 |
| Total Drug Medicare AllowedAmount | 15335.15 |
| Total Drug Medicare PaymentAmount | 12016.75 |
| Total Drug Medicare Standardized Payment Amount | 12016.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 1974 |
| Number Of Medicare Beneficiaries With Medical Services | 628 |
| Total Medical Submitted Charge Amount | 388151 |
| Total Medical Medicare Allowed Amount | 183826.89 |
| Total Medical Medicare Payment Amount | 140783.32 |
| Total Medical Medicare Standardized Payment Amount | 140832.32 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 160 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 187 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 284 |
| Number Of Male Beneficiaries | 345 |
| Number Of Non Hispanic White Beneficiaries | 536 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 449 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 3.8418 |