| National Provider Identifier [NPI]: | 1780686766 |
| Last Name Of The Provider | DUGEL |
| First Name Of The Provider | PRAVIN |
| Middle Initial Of The Provider | U |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 E MISSOURI AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850142709 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 14568 |
| Number Of Medicare Beneficiaries | 1000 |
| Total Submitted Charge Amount | 3977492.84 |
| Total Medicare Allowed Amount | 3913667.62 |
| Total Medicare Payment Amount | 3017560.67 |
| Total Medicare Standardized Payment Amount | 3030330.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 7276 |
| Number Of Medicare Beneficiaries With Drug Services | 272 |
| Total Drug Submitted ChargeAmount | 2998667.25 |
| Total Drug Medicare AllowedAmount | 2964221.15 |
| Total Drug Medicare PaymentAmount | 2311741.03 |
| Total Drug Medicare Standardized Payment Amount | 2311741.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 7292 |
| Number Of Medicare Beneficiaries With Medical Services | 1000 |
| Total Medical Submitted Charge Amount | 978825.59 |
| Total Medical Medicare Allowed Amount | 949446.47 |
| Total Medical Medicare Payment Amount | 705819.64 |
| Total Medical Medicare Standardized Payment Amount | 718589.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 133 |
| Number Of Beneficiaries Age 65 to 74 | 400 |
| Number Of Beneficiaries Age 75 to 84 | 322 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 568 |
| Number Of Male Beneficiaries | 432 |
| Number Of Non Hispanic White Beneficiaries | 540 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 407 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 722 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 278 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.8279 |