| National Provider Identifier [NPI]: | 1689627085 |
| Last Name Of The Provider | VENKATESH |
| First Name Of The Provider | VIJAY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8881 FLETCHER PARKWAY |
| Street Address 2 Of The Provider | #102 |
| City Of The Provider | LA MESA |
| Zip Code Of The Provider | 91942 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 170 |
| Number Of Services | 8126 |
| Number Of Medicare Beneficiaries | 2799 |
| Total Submitted Charge Amount | 846056 |
| Total Medicare Allowed Amount | 199355.78 |
| Total Medicare Payment Amount | 146494.91 |
| Total Medicare Standardized Payment Amount | 143252.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3660 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 10400 |
| Total Drug Medicare AllowedAmount | 1460.37 |
| Total Drug Medicare PaymentAmount | 1144.83 |
| Total Drug Medicare Standardized Payment Amount | 1144.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 168 |
| Number Of Medical Services | 4466 |
| Number Of Medicare Beneficiaries With Medical Services | 2799 |
| Total Medical Submitted Charge Amount | 835656 |
| Total Medical Medicare Allowed Amount | 197895.41 |
| Total Medical Medicare Payment Amount | 145350.08 |
| Total Medical Medicare Standardized Payment Amount | 142107.71 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 569 |
| Number Of Beneficiaries Age 65 to 74 | 904 |
| Number Of Beneficiaries Age 75 to 84 | 780 |
| Number Of Beneficiaries Age Greater 84 | 546 |
| Number Of Female Beneficiaries | 1626 |
| Number Of Male Beneficiaries | 1173 |
| Number Of Non Hispanic White Beneficiaries | 2077 |
| Number Of Black or African American Beneficiaries | 177 |
| Number Of AsianPacific Islander Beneficiaries | 122 |
| Number Of Hispanic Beneficiaries | 339 |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | 66 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1567 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1232 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.0749 |