| National Provider Identifier [NPI]: | 1174560148 |
| Last Name Of The Provider | KOTTAPALLI |
| First Name Of The Provider | AJAY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 90 JACKSON PIKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GALLIPOLIS |
| Zip Code Of The Provider | 456311560 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 1506 |
| Number Of Medicare Beneficiaries | 948 |
| Total Submitted Charge Amount | 134050 |
| Total Medicare Allowed Amount | 107087.47 |
| Total Medicare Payment Amount | 71139.1 |
| Total Medicare Standardized Payment Amount | 74570.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 129 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 6786 |
| Total Drug Medicare AllowedAmount | 3343.47 |
| Total Drug Medicare PaymentAmount | 2601.35 |
| Total Drug Medicare Standardized Payment Amount | 2601.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 1377 |
| Number Of Medicare Beneficiaries With Medical Services | 948 |
| Total Medical Submitted Charge Amount | 127264 |
| Total Medical Medicare Allowed Amount | 103744 |
| Total Medical Medicare Payment Amount | 68537.75 |
| Total Medical Medicare Standardized Payment Amount | 71969.5 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 265 |
| Number Of Beneficiaries Age 65 to 74 | 329 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 76 |
| Number Of Female Beneficiaries | 589 |
| Number Of Male Beneficiaries | 359 |
| Number Of Non Hispanic White Beneficiaries | 914 |
| Number Of Black or African American Beneficiaries | 20 |
| 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 | 630 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 318 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1408 |