| National Provider Identifier [NPI]: | 1770508582 |
| Last Name Of The Provider | DHEERIYA |
| First Name Of The Provider | UJJWALA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 LOMITA BLVD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 90505 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 663 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 133298 |
| Total Medicare Allowed Amount | 98317.91 |
| Total Medicare Payment Amount | 76199.27 |
| Total Medicare Standardized Payment Amount | 71213.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1118 |
| Total Drug Medicare AllowedAmount | 777.2 |
| Total Drug Medicare PaymentAmount | 761.55 |
| Total Drug Medicare Standardized Payment Amount | 761.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 644 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 132180 |
| Total Medical Medicare Allowed Amount | 97540.71 |
| Total Medical Medicare Payment Amount | 75437.72 |
| Total Medical Medicare Standardized Payment Amount | 70451.63 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 42 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 127 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | 144 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 42 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2759 |