| National Provider Identifier [NPI]: | 1780837526 |
| Last Name Of The Provider | MIKKILINENI |
| First Name Of The Provider | HIMABINDU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2600 SIXTH ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | CANTON |
| Zip Code Of The Provider | 447101702 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 2016 |
| Number Of Medicare Beneficiaries | 1570 |
| Total Submitted Charge Amount | 359665 |
| Total Medicare Allowed Amount | 50276.14 |
| Total Medicare Payment Amount | 38335.12 |
| Total Medicare Standardized Payment Amount | 39464.82 |
| 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 | 91 |
| Number Of Medical Services | 2016 |
| Number Of Medicare Beneficiaries With Medical Services | 1570 |
| Total Medical Submitted Charge Amount | 359665 |
| Total Medical Medicare Allowed Amount | 50276.14 |
| Total Medical Medicare Payment Amount | 38335.12 |
| Total Medical Medicare Standardized Payment Amount | 39464.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 397 |
| Number Of Beneficiaries Age 65 to 74 | 434 |
| Number Of Beneficiaries Age 75 to 84 | 394 |
| Number Of Beneficiaries Age Greater 84 | 345 |
| Number Of Female Beneficiaries | 923 |
| Number Of Male Beneficiaries | 647 |
| Number Of Non Hispanic White Beneficiaries | 973 |
| Number Of Black or African American Beneficiaries | 530 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 954 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 616 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3727 |