| National Provider Identifier [NPI]: | 1881858405 |
| Last Name Of The Provider | PONNIAH |
| First Name Of The Provider | CHANDRA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MBBS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2600 W NORFOLK AVE |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | NORFOLK |
| Zip Code Of The Provider | 687014449 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 11048 |
| Number Of Medicare Beneficiaries | 360 |
| Total Submitted Charge Amount | 181056.57 |
| Total Medicare Allowed Amount | 122794.84 |
| Total Medicare Payment Amount | 96415.9 |
| Total Medicare Standardized Payment Amount | 89957.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 2628 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 43970.05 |
| Total Drug Medicare AllowedAmount | 37011.73 |
| Total Drug Medicare PaymentAmount | 28612.35 |
| Total Drug Medicare Standardized Payment Amount | 28612.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 8420 |
| Number Of Medicare Beneficiaries With Medical Services | 360 |
| Total Medical Submitted Charge Amount | 137086.52 |
| Total Medical Medicare Allowed Amount | 85783.11 |
| Total Medical Medicare Payment Amount | 67803.55 |
| Total Medical Medicare Standardized Payment Amount | 61345.52 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 106 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 175 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 305 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.282 |