| National Provider Identifier [NPI]: | 1699706366 |
| Last Name Of The Provider | MISRA |
| First Name Of The Provider | SOURJYA |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13847 E 14TH ST |
| Street Address 2 Of The Provider | SUITE 119 |
| City Of The Provider | SAN LEANDRO |
| Zip Code Of The Provider | 945782632 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 3740 |
| Number Of Medicare Beneficiaries | 624 |
| Total Submitted Charge Amount | 933401.5 |
| Total Medicare Allowed Amount | 390285.52 |
| Total Medicare Payment Amount | 288598.01 |
| Total Medicare Standardized Payment Amount | 259923 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 126 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 119700 |
| Total Drug Medicare AllowedAmount | 27616.33 |
| Total Drug Medicare PaymentAmount | 20970.21 |
| Total Drug Medicare Standardized Payment Amount | 20970.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 3614 |
| Number Of Medicare Beneficiaries With Medical Services | 624 |
| Total Medical Submitted Charge Amount | 813701.5 |
| Total Medical Medicare Allowed Amount | 362669.19 |
| Total Medical Medicare Payment Amount | 267627.8 |
| Total Medical Medicare Standardized Payment Amount | 238952.79 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 235 |
| Number Of Beneficiaries Age 75 to 84 | 205 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 118 |
| Number Of Male Beneficiaries | 506 |
| Number Of Non Hispanic White Beneficiaries | 318 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 116 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 373 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| 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 | 1.4857 |