| National Provider Identifier [NPI]: | 1710073689 |
| Last Name Of The Provider | RATHOD |
| First Name Of The Provider | CHANDRA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4211 N CICERO |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 60641 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2813 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 169209 |
| Total Medicare Allowed Amount | 105442.32 |
| Total Medicare Payment Amount | 78568.92 |
| Total Medicare Standardized Payment Amount | 76380.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 395 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 15239 |
| Total Drug Medicare AllowedAmount | 1253.75 |
| Total Drug Medicare PaymentAmount | 963.67 |
| Total Drug Medicare Standardized Payment Amount | 963.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2418 |
| Number Of Medicare Beneficiaries With Medical Services | 71 |
| Total Medical Submitted Charge Amount | 153970 |
| Total Medical Medicare Allowed Amount | 104188.57 |
| Total Medical Medicare Payment Amount | 77605.25 |
| Total Medical Medicare Standardized Payment Amount | 75417 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 36 |
| Number Of Beneficiaries Age 75 to 84 | 20 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | 47 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 31 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0461 |