RAJAT K DHAR MD
NPI 1023073277
Internal Medicine - Rheumatology in Glendale, AZ

Medicare Participation & PECOS Enrollment Status

Rajat Dhar is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Rajat Dhar is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 9739146291

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20230725001798

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 337 times for 98 patients

Administration of chemotherapy into vein, each additional hour

Chemotherapy is a treatment method that uses drugs to destroy cancer cells. The drugs are administered into a vein, usually in the arm. Each additional hour of chemotherapy allows for more of the medication to enter your bloodstream to fight against the cancer cells.

This service was performed 102 times for 30 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

This service was performed 415 times for 163 patients

Analysis for antibody to coccidioides (bacteria)

This test looks for antibodies to Coccidioides, a fungus that can cause an infection known as Valley Fever. When your body fights this fungus, it produces these antibodies. The test helps to determine if you have been exposed to this fungus.

This service was performed 192 times for 96 patients

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 31 times for 17 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

This service was performed 67 times for 24 patients

Blood test, comprehensive group of blood chemicals

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

This service was performed 622 times for 374 patients

Blood test, thyroid stimulating hormone (tsh)

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

This service was performed 17 times for 17 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 547 times for 319 patients

Creatinine level to test for kidney function or muscle injury

A creatinine level test measures the amount of creatinine in your blood. This substance is a waste product from normal muscle use. Higher levels can indicate possible kidney dysfunction or muscle injury. This test helps monitor kidney health.

This service was performed 16 times for 12 patients

Dxa bone density measurement of forearm, finger, hand, or foot

A DXA bone density measurement of the forearm, finger, hand, or foot is a non-invasive procedure that uses X-rays to measure the amount of calcium and other minerals in your bones. This test helps to assess the strength of your bones and your risk of fractures.

This service was performed 13 times for 13 patients

Dxa bone density measurement of hip, pelvis, spine including spine fracture assessment

A DXA bone density measurement is a non-invasive scan that helps assess the strength of your bones, specifically in the hip, pelvis, and spine areas. It can detect early signs of osteoporosis and evaluate fracture risk. This test uses low-dose X-rays for accurate results.

This service was performed 40 times for 40 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 129 times for 95 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 126 times for 104 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 603 times for 394 patients

Hepatitis b core antibody (igm) measurement

The Hepatitis B Core Antibody (IgM) measurement is a blood test that helps to identify if you have an acute or recent infection of Hepatitis B, a virus that affects the liver. It's not a test for immunity, but rather for detecting active infection.

This service was performed 95 times for 94 patients

Hepatitis c antibody measurement

Hepatitis C antibody measurement is a blood test to check if you have been exposed to the Hepatitis C virus. This virus affects your liver. If the test is positive, it means you have had the virus at some point. Additional tests are needed to determine if the virus is currently active.

This service was performed 95 times for 93 patients

Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.

This service was performed 3,575 times for 13 patients

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

Certolizumab pegol is a medication injected under a doctor's supervision. It's used to treat certain inflammatory conditions like rheumatoid arthritis. The injection helps reduce symptoms like pain and swelling. Note that this drug isn't for self-administration.

This service was performed 32,800 times for 13 patients

Injection, denosumab, 1 mg

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

This service was performed 8,700 times for 133 patients

Injection, golimumab, 1 mg, for intravenous use

Golimumab is a medication given through an IV (a small tube in your vein). It helps to reduce inflammation and pain by blocking a protein in your body that causes inflammation. It's often used to treat conditions like rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

This service was performed 19,300 times for 41 patients

Injection, infliximab, excludes biosimilar, 10 mg

Infliximab is a medication given via injection to treat certain autoimmune conditions. It works by blocking the action of a substance in your body that causes inflammation. Each dose is based on your medical condition and response to treatment.

This service was performed 2,500 times for 19 patients

Injection, romosozumab-aqqg, 1 mg

Romosozumab-aqqg is a medication given by injection to treat osteoporosis in patients at high risk for fractures. It works by increasing bone mass and strength, reducing the risk of fractures.

This service was performed 23,100 times for 25 patients

Injection, tocilizumab, 1 mg

Tocilizumab is a medication administered via injection. It's used to treat certain conditions like rheumatoid arthritis by reducing inflammation in the body. It works by blocking a substance in the body that leads to inflammation.

This service was performed 41,640 times for 16 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

This service was performed 196 times for 45 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 695 times for 396 patients

Measurement c-reactive protein for detection of infection or inflammation

C-reactive protein (CRP) test is a blood test that checks for signs of inflammation or infection in the body. High levels of CRP often suggest that there's inflammation or a bacterial infection. This test helps in monitoring and managing conditions like arthritis and heart disease.

This service was performed 523 times for 287 patients

Measurement of antibody for rheumatoid arthritis assessment

This procedure measures the level of certain antibodies in your blood. These antibodies can be higher in people with rheumatoid arthritis, a condition causing joint inflammation. The test helps in diagnosing or monitoring the disease.

This service was performed 21 times for 21 patients

Measurement of complement (immune system proteins), antigen,

The measurement of complement (immune system proteins) and antigen is a blood test. It helps to assess how your immune system is functioning. Complement proteins play a role in your body's immune response, and antigens trigger this response. This test helps in diagnosing and monitoring certain diseases.

This service was performed 62 times for 24 patients

Measurement of dna antibody, native or double stranded

The measurement of DNA antibody, native or double stranded, is a blood test that helps detect autoimmune disorders, such as lupus. It identifies if your body is producing antibodies against its own DNA, which can indicate an overactive immune response.

This service was performed 31 times for 25 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 33 times for 33 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 85 times for 85 patients

Parathormone (parathyroid hormone) level

The Parathormone level test measures the amount of parathyroid hormone in your blood. This hormone controls calcium and phosphorus levels in the body, which are vital for bone health. Abnormal levels may indicate issues like kidney disease or parathyroid gland disorders.

This service was performed 24 times for 22 patients

Phosphate level

A phosphate level test measures the amount of phosphate in your blood. Phosphate is a chemical that contains the mineral phosphorus, crucial for energy production, muscle and nerve function, and bone growth. Imbalances may indicate kidney disease or other health issues.

This service was performed 18 times for 17 patients

Red blood cell sedimentation rate, to detect inflammation, automated

The Red Blood Cell Sedimentation Rate is a test that helps detect inflammation in the body. It's automated, meaning a machine does the work. This test measures how fast red blood cells settle at the bottom of a tube in an hour. A faster rate may indicate inflammation.

This service was performed 518 times for 288 patients

Rheumatoid factor level

The Rheumatoid Factor Level test is a blood test that helps detect the presence of Rheumatoid Factor (RF), a protein produced by your immune system. High RF levels often indicate autoimmune diseases like rheumatoid arthritis. The test involves a simple blood draw and lab analysis.

This service was performed 20 times for 20 patients

Screening test for autoimmune disorder

A screening test for autoimmune disorders is a medical check-up that helps identify if your body's immune system is attacking its own cells. It involves a simple blood draw and analyzes various markers to detect potential issues. This test aids in early detection and effective treatment.

This service was performed 16 times for 16 patients

Total protein level, urine

The Total Protein Level in urine test measures the amount of protein present in your urine. This helps to check kidney health as high levels may indicate a problem. It's a simple, non-invasive procedure involving a urine sample.

This service was performed 16 times for 12 patients

Tuberculosis test, gamma interferon

A gamma interferon tuberculosis test is a blood test used to diagnose tuberculosis, a serious lung disease. The test measures your immune system's response to TB bacteria. It's a safe, straightforward procedure that can help ensure your health.

This service was performed 79 times for 79 patients

Uric acid level, blood

A blood uric acid level test measures the amount of uric acid in your blood. Uric acid is a waste product that your body produces when it breaks down purines, substances found in your body and in certain foods. High levels may lead to gout or kidney stones.

This service was performed 42 times for 29 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 24 times for 20 patients

Vitamin d-3 level

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

This service was performed 157 times for 144 patients

X-ray of hand, 2 views

An X-ray of the hand, 2 views, is a non-invasive imaging test that uses a small amount of radiation to produce pictures of the bones in your hand. Two different angles are captured to provide a comprehensive view. This helps in diagnosing injuries or conditions affecting your hand.

This service was performed 29 times for 15 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.92 for a new patient copayment and $24.5 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 85306 ZIP code area.

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 93.71, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

• Final Score: 93.71 out of 100

  The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
  
  

• Quality Score: 77.79

  The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category comprises 40% of a provider's final MIPS score.
  
  There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
  
  

• Promoting Interoperability Score: 100

  The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category comprises 25% of a provider's final MIPS score.
  
  The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

• Improvement Activities Score: 40

  The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category comprises 15% of a provider's final MIPS score.
  
  The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category comprises 15% of a provider's final MIPS score.

• Cost Score: N/A

  The Cost performance category assesses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
  
  Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category comprises 20% of a provider's final MIPS score.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

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