National Provider Identifier [NPI]: |
1821014960 |
Last Name Of The Provider |
CHAURUSHIYA |
First Name Of The Provider |
PURNIMA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1798 N GAREY AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
POMONA |
Zip Code Of The Provider |
917672918 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pathology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1612 |
Number Of Medicare Beneficiaries |
539 |
Total Submitted Charge Amount |
250850 |
Total Medicare Allowed Amount |
61043.3 |
Total Medicare Payment Amount |
47487.34 |
Total Medicare Standardized Payment Amount |
35486.79 |
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 |
29 |
Number Of Medical Services |
1612 |
Number Of Medicare Beneficiaries With Medical Services |
539 |
Total Medical Submitted Charge Amount |
250850 |
Total Medical Medicare Allowed Amount |
61043.3 |
Total Medical Medicare Payment Amount |
47487.34 |
Total Medical Medicare Standardized Payment Amount |
35486.79 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
109 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
154 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
253 |
Number Of Non Hispanic White Beneficiaries |
230 |
Number Of Black or African American Beneficiaries |
62 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
183 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
228 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
311 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.2681 |