National Provider Identifier [NPI]: |
1740388933 |
Last Name Of The Provider |
CHINNASWAMY |
First Name Of The Provider |
CHITRA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1801 NW PLATTE RD |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
RIVERSIDE |
Zip Code Of The Provider |
641507509 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
756 |
Number Of Medicare Beneficiaries |
201 |
Total Submitted Charge Amount |
82285 |
Total Medicare Allowed Amount |
75050.33 |
Total Medicare Payment Amount |
50171.69 |
Total Medicare Standardized Payment Amount |
52505 |
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 |
5 |
Number Of Medical Services |
756 |
Number Of Medicare Beneficiaries With Medical Services |
201 |
Total Medical Submitted Charge Amount |
82285 |
Total Medical Medicare Allowed Amount |
75050.33 |
Total Medical Medicare Payment Amount |
50171.69 |
Total Medical Medicare Standardized Payment Amount |
52505 |
Average Age Of Beneficiaries |
62 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
53 |
Number Of Non Hispanic White Beneficiaries |
183 |
Number Of Black or African American Beneficiaries |
|
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 |
144 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
57 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
15 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1506 |