| National Provider Identifier [NPI]: | 1003057274 |
| Last Name Of The Provider | ECHEVERRIA |
| First Name Of The Provider | JUAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10833 LE CONTE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900953075 |
| 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 | 217 |
| Number Of Services | 6042 |
| Number Of Medicare Beneficiaries | 2983 |
| Total Submitted Charge Amount | 972321.7 |
| Total Medicare Allowed Amount | 234660.57 |
| Total Medicare Payment Amount | 175360.2 |
| Total Medicare Standardized Payment Amount | 168582.71 |
| 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 | 217 |
| Number Of Medical Services | 6042 |
| Number Of Medicare Beneficiaries With Medical Services | 2983 |
| Total Medical Submitted Charge Amount | 972321.7 |
| Total Medical Medicare Allowed Amount | 234660.57 |
| Total Medical Medicare Payment Amount | 175360.2 |
| Total Medical Medicare Standardized Payment Amount | 168582.71 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 585 |
| Number Of Beneficiaries Age 65 to 74 | 884 |
| Number Of Beneficiaries Age 75 to 84 | 942 |
| Number Of Beneficiaries Age Greater 84 | 572 |
| Number Of Female Beneficiaries | 1773 |
| Number Of Male Beneficiaries | 1210 |
| Number Of Non Hispanic White Beneficiaries | 434 |
| Number Of Black or African American Beneficiaries | 284 |
| Number Of AsianPacific Islander Beneficiaries | 1105 |
| Number Of Hispanic Beneficiaries | 1074 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2261 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 2.743 |