| National Provider Identifier [NPI]: | 1114000734 |
| Last Name Of The Provider | ATHREYA |
| First Name Of The Provider | RANI |
| Middle Initial Of The Provider | U |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3300 MAIN ST |
| Street Address 2 Of The Provider | 3RD FLOOR SUITE C&D |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011991002 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 5200 |
| Number Of Medicare Beneficiaries | 324 |
| Total Submitted Charge Amount | 217680.42 |
| Total Medicare Allowed Amount | 111375.67 |
| Total Medicare Payment Amount | 83110.04 |
| Total Medicare Standardized Payment Amount | 81770.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4500 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 29240 |
| Total Drug Medicare AllowedAmount | 24799.5 |
| Total Drug Medicare PaymentAmount | 19297.18 |
| Total Drug Medicare Standardized Payment Amount | 19297.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 700 |
| Number Of Medicare Beneficiaries With Medical Services | 324 |
| Total Medical Submitted Charge Amount | 188440.42 |
| Total Medical Medicare Allowed Amount | 86576.17 |
| Total Medical Medicare Payment Amount | 63812.86 |
| Total Medical Medicare Standardized Payment Amount | 62473.37 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 111 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 197 |
| Number Of Male Beneficiaries | 127 |
| Number Of Non Hispanic White Beneficiaries | 256 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 195 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3835 |