| National Provider Identifier [NPI]: | 1932153731 |
| Last Name Of The Provider | BISWAS |
| First Name Of The Provider | MAHUA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4640 ADMIRALTY WAY |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | MARINA DEL REY |
| Zip Code Of The Provider | 902926629 |
| 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 | 205 |
| Number Of Services | 6092 |
| Number Of Medicare Beneficiaries | 2805 |
| Total Submitted Charge Amount | 648113.36 |
| Total Medicare Allowed Amount | 172588.31 |
| Total Medicare Payment Amount | 128130.18 |
| Total Medicare Standardized Payment Amount | 121937.32 |
| 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 | 205 |
| Number Of Medical Services | 6092 |
| Number Of Medicare Beneficiaries With Medical Services | 2805 |
| Total Medical Submitted Charge Amount | 648113.36 |
| Total Medical Medicare Allowed Amount | 172588.31 |
| Total Medical Medicare Payment Amount | 128130.18 |
| Total Medical Medicare Standardized Payment Amount | 121937.32 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 677 |
| Number Of Beneficiaries Age 65 to 74 | 879 |
| Number Of Beneficiaries Age 75 to 84 | 715 |
| Number Of Beneficiaries Age Greater 84 | 534 |
| Number Of Female Beneficiaries | 1520 |
| Number Of Male Beneficiaries | 1285 |
| Number Of Non Hispanic White Beneficiaries | 691 |
| Number Of Black or African American Beneficiaries | 836 |
| Number Of AsianPacific Islander Beneficiaries | 169 |
| Number Of Hispanic Beneficiaries | 1044 |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 629 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2176 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 64 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 3.0715 |