National Provider Identifier [NPI]: |
1578530804 |
Last Name Of The Provider |
LOKE |
First Name Of The Provider |
CHANDRAVATHI |
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 |
3350 MAIN STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
011991619 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
720 |
Number Of Medicare Beneficiaries |
277 |
Total Submitted Charge Amount |
165278 |
Total Medicare Allowed Amount |
60620.24 |
Total Medicare Payment Amount |
44856.01 |
Total Medicare Standardized Payment Amount |
44896.43 |
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 |
17 |
Number Of Medical Services |
720 |
Number Of Medicare Beneficiaries With Medical Services |
277 |
Total Medical Submitted Charge Amount |
165278 |
Total Medical Medicare Allowed Amount |
60620.24 |
Total Medical Medicare Payment Amount |
44856.01 |
Total Medical Medicare Standardized Payment Amount |
44896.43 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
115 |
Number Of Beneficiaries Age 75 to 84 |
64 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
170 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
32 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
106 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
40 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.9134 |