| National Provider Identifier [NPI]: | 1679505333 |
| Last Name Of The Provider | NIEVES |
| First Name Of The Provider | MIGUEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6305 COYLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARMICHAEL |
| Zip Code Of The Provider | 956080438 |
| 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 | 156 |
| Number Of Services | 11799 |
| Number Of Medicare Beneficiaries | 2172 |
| Total Submitted Charge Amount | 1095203.1 |
| Total Medicare Allowed Amount | 198210.8 |
| Total Medicare Payment Amount | 152393.39 |
| Total Medicare Standardized Payment Amount | 147984.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 8569 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 20849.3 |
| Total Drug Medicare AllowedAmount | 3105.32 |
| Total Drug Medicare PaymentAmount | 2434.51 |
| Total Drug Medicare Standardized Payment Amount | 2434.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 152 |
| Number Of Medical Services | 3230 |
| Number Of Medicare Beneficiaries With Medical Services | 2172 |
| Total Medical Submitted Charge Amount | 1074353.8 |
| Total Medical Medicare Allowed Amount | 195105.48 |
| Total Medical Medicare Payment Amount | 149958.88 |
| Total Medical Medicare Standardized Payment Amount | 145549.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 480 |
| Number Of Beneficiaries Age 65 to 74 | 748 |
| Number Of Beneficiaries Age 75 to 84 | 576 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 1181 |
| Number Of Male Beneficiaries | 991 |
| Number Of Non Hispanic White Beneficiaries | 1292 |
| Number Of Black or African American Beneficiaries | 256 |
| Number Of AsianPacific Islander Beneficiaries | 316 |
| Number Of Hispanic Beneficiaries | 240 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1000 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 1.9576 |