| National Provider Identifier [NPI]: | 1063497139 |
| Last Name Of The Provider | AGRAWAL |
| First Name Of The Provider | MANJU |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5201 HARRY HINES BLVD |
| Street Address 2 Of The Provider | AMBULATORY CARE CLINIC |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752357708 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 1343 |
| Number Of Medicare Beneficiaries | 603 |
| Total Submitted Charge Amount | 188584 |
| Total Medicare Allowed Amount | 83077.56 |
| Total Medicare Payment Amount | 52551.9 |
| Total Medicare Standardized Payment Amount | 57060.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 2713 |
| Total Drug Medicare AllowedAmount | 500.03 |
| Total Drug Medicare PaymentAmount | 288.8 |
| Total Drug Medicare Standardized Payment Amount | 288.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 1237 |
| Number Of Medicare Beneficiaries With Medical Services | 603 |
| Total Medical Submitted Charge Amount | 185871 |
| Total Medical Medicare Allowed Amount | 82577.53 |
| Total Medical Medicare Payment Amount | 52263.1 |
| Total Medical Medicare Standardized Payment Amount | 56771.86 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 316 |
| Number Of Beneficiaries Age 75 to 84 | 182 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 412 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 522 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 553 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8334 |