| National Provider Identifier [NPI]: | 1003806308 |
| Last Name Of The Provider | MANIKANTAN |
| First Name Of The Provider | POORNACHANDRAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 908 ALLEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011182533 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 1242 |
| Number Of Medicare Beneficiaries | 526 |
| Total Submitted Charge Amount | 501153 |
| Total Medicare Allowed Amount | 98526.92 |
| Total Medicare Payment Amount | 74683.36 |
| Total Medicare Standardized Payment Amount | 75062.41 |
| 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 | 103 |
| Number Of Medical Services | 1242 |
| Number Of Medicare Beneficiaries With Medical Services | 526 |
| Total Medical Submitted Charge Amount | 501153 |
| Total Medical Medicare Allowed Amount | 98526.92 |
| Total Medical Medicare Payment Amount | 74683.36 |
| Total Medical Medicare Standardized Payment Amount | 75062.41 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 109 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 321 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 281 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 245 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2078 |