| National Provider Identifier [NPI]: | 1184684987 |
| Last Name Of The Provider | CHITNENI |
| First Name Of The Provider | SHOBHA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1351 KIMBERLY RD |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | BETTENDORF |
| Zip Code Of The Provider | 527224193 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 70943 |
| Number Of Medicare Beneficiaries | 582 |
| Total Submitted Charge Amount | 2037578.34 |
| Total Medicare Allowed Amount | 983357.77 |
| Total Medicare Payment Amount | 763287.75 |
| Total Medicare Standardized Payment Amount | 772293.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 51 |
| Number Of Drug Services | 68107 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 1665419.05 |
| Total Drug Medicare AllowedAmount | 776968.15 |
| Total Drug Medicare PaymentAmount | 608543.34 |
| Total Drug Medicare Standardized Payment Amount | 608543.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 2836 |
| Number Of Medicare Beneficiaries With Medical Services | 582 |
| Total Medical Submitted Charge Amount | 372159.29 |
| Total Medical Medicare Allowed Amount | 206389.62 |
| Total Medical Medicare Payment Amount | 154744.41 |
| Total Medical Medicare Standardized Payment Amount | 163750.36 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 253 |
| Number Of Beneficiaries Age 75 to 84 | 200 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 390 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 537 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 508 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.5024 |