| National Provider Identifier [NPI]: | 1609801356 |
| Last Name Of The Provider | CHAKRABORTY |
| First Name Of The Provider | SUPARNA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 W RANDOL MILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ARLINGTON |
| Zip Code Of The Provider | 760122504 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 1086 |
| Number Of Medicare Beneficiaries | 324 |
| Total Submitted Charge Amount | 272518 |
| Total Medicare Allowed Amount | 114898.71 |
| Total Medicare Payment Amount | 89242.65 |
| Total Medicare Standardized Payment Amount | 90266.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 1086 |
| Number Of Medicare Beneficiaries With Medical Services | 324 |
| Total Medical Submitted Charge Amount | 272518 |
| Total Medical Medicare Allowed Amount | 114898.71 |
| Total Medical Medicare Payment Amount | 89242.65 |
| Total Medical Medicare Standardized Payment Amount | 90266.41 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 194 |
| Number Of Male Beneficiaries | 130 |
| Number Of Non Hispanic White Beneficiaries | 286 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 263 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 61 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.2963 |