| National Provider Identifier [NPI]: | 1215967955 |
| Last Name Of The Provider | KARAVASILIS |
| First Name Of The Provider | ANGELA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 460 AMHERST ST |
| Street Address 2 Of The Provider | SJ FAMILY MEDICAL CENTER |
| City Of The Provider | NASHUA |
| Zip Code Of The Provider | 030631220 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 469 |
| Number Of Medicare Beneficiaries | 176 |
| Total Submitted Charge Amount | 68798.58 |
| Total Medicare Allowed Amount | 40898.47 |
| Total Medicare Payment Amount | 27502.16 |
| Total Medicare Standardized Payment Amount | 27642.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 865 |
| Total Drug Medicare AllowedAmount | 578.72 |
| Total Drug Medicare PaymentAmount | 566.15 |
| Total Drug Medicare Standardized Payment Amount | 566.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 437 |
| Number Of Medicare Beneficiaries With Medical Services | 176 |
| Total Medical Submitted Charge Amount | 67933.58 |
| Total Medical Medicare Allowed Amount | 40319.75 |
| Total Medical Medicare Payment Amount | 26936.01 |
| Total Medical Medicare Standardized Payment Amount | 27076.53 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 18 |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 30 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8624 |