| National Provider Identifier [NPI]: | 1801826938 |
| Last Name Of The Provider | DHANEKULA |
| First Name Of The Provider | LEELA |
| 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 | 5405 N KNOXVILLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 616145016 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 4636 |
| Number Of Medicare Beneficiaries | 1651 |
| Total Submitted Charge Amount | 974297.66 |
| Total Medicare Allowed Amount | 254598.73 |
| Total Medicare Payment Amount | 192126.07 |
| Total Medicare Standardized Payment Amount | 196021.65 |
| 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 | 87 |
| Number Of Medical Services | 4636 |
| Number Of Medicare Beneficiaries With Medical Services | 1651 |
| Total Medical Submitted Charge Amount | 974297.66 |
| Total Medical Medicare Allowed Amount | 254598.73 |
| Total Medical Medicare Payment Amount | 192126.07 |
| Total Medical Medicare Standardized Payment Amount | 196021.65 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | 517 |
| Number Of Beneficiaries Age 75 to 84 | 562 |
| Number Of Beneficiaries Age Greater 84 | 386 |
| Number Of Female Beneficiaries | 808 |
| Number Of Male Beneficiaries | 843 |
| Number Of Non Hispanic White Beneficiaries | 1531 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1362 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 289 |
| Percent Of With Atrial Fibrillation | 41 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7265 |