| National Provider Identifier [NPI]: | 1871655480 |
| Last Name Of The Provider | TAMBOLI |
| First Name Of The Provider | KAUSHAL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8317 DAVIS ST |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | DOWNEY |
| Zip Code Of The Provider | 902414918 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 4834 |
| Number Of Medicare Beneficiaries | 932 |
| Total Submitted Charge Amount | 1021460 |
| Total Medicare Allowed Amount | 454262.11 |
| Total Medicare Payment Amount | 339889.16 |
| Total Medicare Standardized Payment Amount | 312886.9 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 363 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 43405 |
| Total Drug Medicare AllowedAmount | 15508.01 |
| Total Drug Medicare PaymentAmount | 11649.16 |
| Total Drug Medicare Standardized Payment Amount | 11649.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 4471 |
| Number Of Medicare Beneficiaries With Medical Services | 931 |
| Total Medical Submitted Charge Amount | 978055 |
| Total Medical Medicare Allowed Amount | 438754.1 |
| Total Medical Medicare Payment Amount | 328240 |
| Total Medical Medicare Standardized Payment Amount | 301237.74 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 271 |
| Number Of Beneficiaries Age 75 to 84 | 327 |
| Number Of Beneficiaries Age Greater 84 | 240 |
| Number Of Female Beneficiaries | 524 |
| Number Of Male Beneficiaries | 408 |
| Number Of Non Hispanic White Beneficiaries | 331 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 459 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 391 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 541 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1237 |