| National Provider Identifier [NPI]: | 1760692529 |
| Last Name Of The Provider | AGENO |
| First Name Of The Provider | SHAUN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3181 SW SAM JACKSON PARK RD # UHN-62 |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972393011 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 3346 |
| Number Of Medicare Beneficiaries | 1410 |
| Total Submitted Charge Amount | 537410.7 |
| Total Medicare Allowed Amount | 198576.67 |
| Total Medicare Payment Amount | 150594.92 |
| Total Medicare Standardized Payment Amount | 153454.78 |
| 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 | 76 |
| Number Of Medical Services | 3346 |
| Number Of Medicare Beneficiaries With Medical Services | 1410 |
| Total Medical Submitted Charge Amount | 537410.7 |
| Total Medical Medicare Allowed Amount | 198576.67 |
| Total Medical Medicare Payment Amount | 150594.92 |
| Total Medical Medicare Standardized Payment Amount | 153454.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 228 |
| Number Of Beneficiaries Age 65 to 74 | 469 |
| Number Of Beneficiaries Age 75 to 84 | 441 |
| Number Of Beneficiaries Age Greater 84 | 272 |
| Number Of Female Beneficiaries | 701 |
| Number Of Male Beneficiaries | 709 |
| Number Of Non Hispanic White Beneficiaries | 1344 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1056 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 354 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6544 |