National Provider Identifier [NPI]: |
1215002191 |
Last Name Of The Provider |
CHAUDHARY |
First Name Of The Provider |
KESAR |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9801 GEORGIA AVE |
Street Address 2 Of The Provider |
SUITE 118 |
City Of The Provider |
SILVER SPRING |
Zip Code Of The Provider |
209025276 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
322 |
Number Of Medicare Beneficiaries |
112 |
Total Submitted Charge Amount |
31277 |
Total Medicare Allowed Amount |
18817.94 |
Total Medicare Payment Amount |
12530.54 |
Total Medicare Standardized Payment Amount |
12985.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
735 |
Total Drug Medicare AllowedAmount |
226.41 |
Total Drug Medicare PaymentAmount |
204.59 |
Total Drug Medicare Standardized Payment Amount |
204.59 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
302 |
Number Of Medicare Beneficiaries With Medical Services |
112 |
Total Medical Submitted Charge Amount |
30542 |
Total Medical Medicare Allowed Amount |
18591.53 |
Total Medical Medicare Payment Amount |
12325.95 |
Total Medical Medicare Standardized Payment Amount |
12780.91 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
55 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
81 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
90 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8885 |