| National Provider Identifier [NPI]: | 1740283118 |
| Last Name Of The Provider | MONGA |
| First Name Of The Provider | ASHISH |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12700 PARK CENTRAL DR |
| Street Address 2 Of The Provider | STE 430 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752511527 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 138 |
| Number Of Services | 3401 |
| Number Of Medicare Beneficiaries | 2495 |
| Total Submitted Charge Amount | 328747 |
| Total Medicare Allowed Amount | 97843.74 |
| Total Medicare Payment Amount | 74972.35 |
| Total Medicare Standardized Payment Amount | 76082.37 |
| 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 | 138 |
| Number Of Medical Services | 3401 |
| Number Of Medicare Beneficiaries With Medical Services | 2495 |
| Total Medical Submitted Charge Amount | 328747 |
| Total Medical Medicare Allowed Amount | 97843.74 |
| Total Medical Medicare Payment Amount | 74972.35 |
| Total Medical Medicare Standardized Payment Amount | 76082.37 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 337 |
| Number Of Beneficiaries Age 65 to 74 | 1132 |
| Number Of Beneficiaries Age 75 to 84 | 697 |
| Number Of Beneficiaries Age Greater 84 | 329 |
| Number Of Female Beneficiaries | 1458 |
| Number Of Male Beneficiaries | 1037 |
| Number Of Non Hispanic White Beneficiaries | 1976 |
| Number Of Black or African American Beneficiaries | 254 |
| Number Of AsianPacific Islander Beneficiaries | 65 |
| Number Of Hispanic Beneficiaries | 151 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 376 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6523 |