| National Provider Identifier [NPI]: | 1306868963 |
| Last Name Of The Provider | KOTHEGAL |
| First Name Of The Provider | HARI |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4420 AICHOLTZ RD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452451761 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 1413 |
| Number Of Medicare Beneficiaries | 300 |
| Total Submitted Charge Amount | 268547 |
| Total Medicare Allowed Amount | 131502.22 |
| Total Medicare Payment Amount | 99166.59 |
| Total Medicare Standardized Payment Amount | 103120.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 95 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 53760 |
| Total Drug Medicare AllowedAmount | 18174.34 |
| Total Drug Medicare PaymentAmount | 14223.5 |
| Total Drug Medicare Standardized Payment Amount | 14223.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 1318 |
| Number Of Medicare Beneficiaries With Medical Services | 300 |
| Total Medical Submitted Charge Amount | 214787 |
| Total Medical Medicare Allowed Amount | 113327.88 |
| Total Medical Medicare Payment Amount | 84943.09 |
| Total Medical Medicare Standardized Payment Amount | 88896.52 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 87 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 215 |
| 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 | 219 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3552 |