| National Provider Identifier [NPI]: | 1942236682 |
| Last Name Of The Provider | BHAIRAVARASU |
| First Name Of The Provider | KALPANA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 W 5TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ODESSA |
| Zip Code Of The Provider | 797634206 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 879 |
| Number Of Medicare Beneficiaries | 252 |
| Total Submitted Charge Amount | 88219.5 |
| Total Medicare Allowed Amount | 59257.56 |
| Total Medicare Payment Amount | 43808.52 |
| Total Medicare Standardized Payment Amount | 45853.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 293 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 21866 |
| Total Drug Medicare AllowedAmount | 14976.82 |
| Total Drug Medicare PaymentAmount | 11788.54 |
| Total Drug Medicare Standardized Payment Amount | 11788.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 586 |
| Number Of Medicare Beneficiaries With Medical Services | 252 |
| Total Medical Submitted Charge Amount | 66353.5 |
| Total Medical Medicare Allowed Amount | 44280.74 |
| Total Medical Medicare Payment Amount | 32019.98 |
| Total Medical Medicare Standardized Payment Amount | 34065.02 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 89 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 77 |
| Number Of Non Hispanic White Beneficiaries | 117 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 104 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 142 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4247 |