National Provider Identifier [NPI]: |
1942265509 |
Last Name Of The Provider |
AMARA |
First Name Of The Provider |
CHANDRAMOULESWAR |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
269 MEDICAL PARK BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PETERSBURG |
Zip Code Of The Provider |
238059337 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
7 |
Number Of Services |
2325 |
Number Of Medicare Beneficiaries |
345 |
Total Submitted Charge Amount |
309800 |
Total Medicare Allowed Amount |
184853.89 |
Total Medicare Payment Amount |
138735.85 |
Total Medicare Standardized Payment Amount |
144210.02 |
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 |
7 |
Number Of Medical Services |
2325 |
Number Of Medicare Beneficiaries With Medical Services |
345 |
Total Medical Submitted Charge Amount |
309800 |
Total Medical Medicare Allowed Amount |
184853.89 |
Total Medical Medicare Payment Amount |
138735.85 |
Total Medical Medicare Standardized Payment Amount |
144210.02 |
Average Age Of Beneficiaries |
45 |
Number Of Beneficiaries Age Less65 |
316 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
171 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
191 |
Number Of Black or African American Beneficiaries |
141 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
255 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
18 |
Percent Of With Schizophrenia Other PsychoticDisorders |
67 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0882 |