| National Provider Identifier [NPI]: | 1881604239 |
| Last Name Of The Provider | CHAKRABORTTY |
| First Name Of The Provider | SAGHANA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1020 INDEPENDENCE BLVD |
| Street Address 2 Of The Provider | SUITE 305 |
| City Of The Provider | VIRGINIA BEACH |
| Zip Code Of The Provider | 234555500 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1224 |
| Number Of Medicare Beneficiaries | 192 |
| Total Submitted Charge Amount | 266153 |
| Total Medicare Allowed Amount | 91427.65 |
| Total Medicare Payment Amount | 67233.04 |
| Total Medicare Standardized Payment Amount | 68614.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 97 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 5429 |
| Total Drug Medicare AllowedAmount | 2365.07 |
| Total Drug Medicare PaymentAmount | 2295.51 |
| Total Drug Medicare Standardized Payment Amount | 2295.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1127 |
| Number Of Medicare Beneficiaries With Medical Services | 191 |
| Total Medical Submitted Charge Amount | 260724 |
| Total Medical Medicare Allowed Amount | 89062.58 |
| Total Medical Medicare Payment Amount | 64937.53 |
| Total Medical Medicare Standardized Payment Amount | 66318.94 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 73 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 98 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1938 |