National Provider Identifier [NPI]: |
1467458216 |
Last Name Of The Provider |
PERERA |
First Name Of The Provider |
CHANNA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
755 CAMPBELL AVE STE 3 |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST HAVEN |
Zip Code Of The Provider |
065163715 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1301 |
Number Of Medicare Beneficiaries |
489 |
Total Submitted Charge Amount |
179329 |
Total Medicare Allowed Amount |
127481.54 |
Total Medicare Payment Amount |
94102.35 |
Total Medicare Standardized Payment Amount |
93498.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
38 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
594 |
Total Drug Medicare AllowedAmount |
570.49 |
Total Drug Medicare PaymentAmount |
558.62 |
Total Drug Medicare Standardized Payment Amount |
558.62 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1263 |
Number Of Medicare Beneficiaries With Medical Services |
489 |
Total Medical Submitted Charge Amount |
178735 |
Total Medical Medicare Allowed Amount |
126911.05 |
Total Medical Medicare Payment Amount |
93543.73 |
Total Medical Medicare Standardized Payment Amount |
92939.79 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
139 |
Number Of Beneficiaries Age Greater 84 |
189 |
Number Of Female Beneficiaries |
304 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
420 |
Number Of Black or African American Beneficiaries |
43 |
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 |
263 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
226 |
Percent Of With Atrial Fibrillation |
27 |
Percent Of With Alzheimers Disease or Dementia |
40 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.0917 |