| National Provider Identifier [NPI]: | 1730165481 |
| Last Name Of The Provider | KOOLWAL |
| First Name Of The Provider | HARISH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 214 W SAM HOUSTON BLVD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | PHARR |
| Zip Code Of The Provider | 785775346 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 4905 |
| Number Of Medicare Beneficiaries | 877 |
| Total Submitted Charge Amount | 1125150 |
| Total Medicare Allowed Amount | 533596.3 |
| Total Medicare Payment Amount | 403754.3 |
| Total Medicare Standardized Payment Amount | 400925.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 688 |
| Number Of Medicare Beneficiaries With Drug Services | 172 |
| Total Drug Submitted ChargeAmount | 82560 |
| Total Drug Medicare AllowedAmount | 36456.54 |
| Total Drug Medicare PaymentAmount | 28416.22 |
| Total Drug Medicare Standardized Payment Amount | 28416.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 4217 |
| Number Of Medicare Beneficiaries With Medical Services | 877 |
| Total Medical Submitted Charge Amount | 1042590 |
| Total Medical Medicare Allowed Amount | 497139.76 |
| Total Medical Medicare Payment Amount | 375338.08 |
| Total Medical Medicare Standardized Payment Amount | 372508.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 155 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 289 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 457 |
| Number Of Male Beneficiaries | 420 |
| Number Of Non Hispanic White Beneficiaries | 169 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 696 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 549 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 67 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.8869 |