| National Provider Identifier [NPI]: | 1245324201 |
| Last Name Of The Provider | JENGO |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1045 ATLANTIC AVE |
| Street Address 2 Of The Provider | SUITE 912 |
| City Of The Provider | LONG BEACH |
| Zip Code Of The Provider | 908133408 |
| 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 | 29 |
| Number Of Services | 2685 |
| Number Of Medicare Beneficiaries | 860 |
| Total Submitted Charge Amount | 277605.01 |
| Total Medicare Allowed Amount | 150407.5 |
| Total Medicare Payment Amount | 112463.4 |
| Total Medicare Standardized Payment Amount | 104612.06 |
| 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 | 2685 |
| Number Of Medicare Beneficiaries With Medical Services | 860 |
| Total Medical Submitted Charge Amount | 277605.01 |
| Total Medical Medicare Allowed Amount | 150407.5 |
| Total Medical Medicare Payment Amount | 112463.4 |
| Total Medical Medicare Standardized Payment Amount | 104612.06 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 148 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 244 |
| Number Of Beneficiaries Age Greater 84 | 174 |
| Number Of Female Beneficiaries | 451 |
| Number Of Male Beneficiaries | 409 |
| Number Of Non Hispanic White Beneficiaries | 470 |
| Number Of Black or African American Beneficiaries | 130 |
| Number Of AsianPacific Islander Beneficiaries | 81 |
| Number Of Hispanic Beneficiaries | 158 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 455 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 405 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.8317 |