| National Provider Identifier [NPI]: | 1659705762 |
| Last Name Of The Provider | KHANNA |
| First Name Of The Provider | PRADEEP |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1851 OLD MOULTRIE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320844168 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 723 |
| Number Of Medicare Beneficiaries | 259 |
| Total Submitted Charge Amount | 82486 |
| Total Medicare Allowed Amount | 70483.09 |
| Total Medicare Payment Amount | 50941.69 |
| Total Medicare Standardized Payment Amount | 52044.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 780 |
| Total Drug Medicare AllowedAmount | 393.65 |
| Total Drug Medicare PaymentAmount | 385.8 |
| Total Drug Medicare Standardized Payment Amount | 385.8 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 699 |
| Number Of Medicare Beneficiaries With Medical Services | 259 |
| Total Medical Submitted Charge Amount | 81706 |
| Total Medical Medicare Allowed Amount | 70089.44 |
| Total Medical Medicare Payment Amount | 50555.89 |
| Total Medical Medicare Standardized Payment Amount | 51658.69 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 95 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 129 |
| Number Of Non Hispanic White Beneficiaries | 218 |
| 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 | 143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 116 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1271 |