| National Provider Identifier [NPI]: | 1770553562 |
| Last Name Of The Provider | BEGOLLI |
| First Name Of The Provider | VANESSA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 230 MAPLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOLYOKE |
| Zip Code Of The Provider | 010405124 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 277 |
| Number Of Medicare Beneficiaries | 75 |
| Total Submitted Charge Amount | 5559 |
| Total Medicare Allowed Amount | 3585.5 |
| Total Medicare Payment Amount | 2836.11 |
| Total Medicare Standardized Payment Amount | 3010.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 30 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 409 |
| Total Drug Medicare AllowedAmount | 402.92 |
| Total Drug Medicare PaymentAmount | 394.8 |
| Total Drug Medicare Standardized Payment Amount | 394.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 247 |
| Number Of Medicare Beneficiaries With Medical Services | 75 |
| Total Medical Submitted Charge Amount | 5150 |
| Total Medical Medicare Allowed Amount | 3182.58 |
| Total Medical Medicare Payment Amount | 2441.31 |
| Total Medical Medicare Standardized Payment Amount | 2616.06 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 49 |
| Number Of Male Beneficiaries | 26 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 11 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 16 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.367 |