| National Provider Identifier [NPI]: | 1154499481 |
| Last Name Of The Provider | CHELLIAH |
| First Name Of The Provider | NIRMALA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | EASTVIEW INTERNAL MEDICINE, P.C. 3285 SALEM ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | COVINGTON |
| Zip Code Of The Provider | 300161863 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 608 |
| Number Of Medicare Beneficiaries | 43 |
| Total Submitted Charge Amount | 53853 |
| Total Medicare Allowed Amount | 29928.59 |
| Total Medicare Payment Amount | 22414.51 |
| Total Medicare Standardized Payment Amount | 22359.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 66 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 1210 |
| Total Drug Medicare AllowedAmount | 235.68 |
| Total Drug Medicare PaymentAmount | 217.54 |
| Total Drug Medicare Standardized Payment Amount | 217.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 542 |
| Number Of Medicare Beneficiaries With Medical Services | 43 |
| Total Medical Submitted Charge Amount | 52643 |
| Total Medical Medicare Allowed Amount | 29692.91 |
| Total Medical Medicare Payment Amount | 22196.97 |
| Total Medical Medicare Standardized Payment Amount | 22141.9 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 19 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 31 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 23 |
| 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 | 23 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 0 |
| 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 | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0683 |