| National Provider Identifier [NPI]: | 1932114774 |
| Last Name Of The Provider | DAMERA |
| First Name Of The Provider | SRIDEVI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2040 N SHADELAND AVE |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462191711 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1420 |
| Number Of Medicare Beneficiaries | 278 |
| Total Submitted Charge Amount | 136728 |
| Total Medicare Allowed Amount | 96504.73 |
| Total Medicare Payment Amount | 69138.33 |
| Total Medicare Standardized Payment Amount | 74572.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 143 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 7689 |
| Total Drug Medicare AllowedAmount | 5019.55 |
| Total Drug Medicare PaymentAmount | 4741.27 |
| Total Drug Medicare Standardized Payment Amount | 4741.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1277 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 129039 |
| Total Medical Medicare Allowed Amount | 91485.18 |
| Total Medical Medicare Payment Amount | 64397.06 |
| Total Medical Medicare Standardized Payment Amount | 69831.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 101 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 214 |
| Number Of Male Beneficiaries | 64 |
| Number Of Non Hispanic White Beneficiaries | 210 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1751 |