| National Provider Identifier [NPI]: | 1568405181 |
| Last Name Of The Provider | TUMMALA |
| First Name Of The Provider | MADHUSUDANA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 HURLEY PLZ |
| Street Address 2 Of The Provider | HURLEY MEDICAL CENTER |
| City Of The Provider | FLINT |
| Zip Code Of The Provider | 485035902 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 170 |
| Number Of Services | 7039 |
| Number Of Medicare Beneficiaries | 1530 |
| Total Submitted Charge Amount | 244985 |
| Total Medicare Allowed Amount | 95975.44 |
| Total Medicare Payment Amount | 74190.28 |
| Total Medicare Standardized Payment Amount | 78840.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4300 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 8514 |
| Total Drug Medicare AllowedAmount | 860.64 |
| Total Drug Medicare PaymentAmount | 674.78 |
| Total Drug Medicare Standardized Payment Amount | 674.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 2739 |
| Number Of Medicare Beneficiaries With Medical Services | 1530 |
| Total Medical Submitted Charge Amount | 236471 |
| Total Medical Medicare Allowed Amount | 95114.8 |
| Total Medical Medicare Payment Amount | 73515.5 |
| Total Medical Medicare Standardized Payment Amount | 78165.89 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 491 |
| Number Of Beneficiaries Age 65 to 74 | 496 |
| Number Of Beneficiaries Age 75 to 84 | 353 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 896 |
| Number Of Male Beneficiaries | 634 |
| Number Of Non Hispanic White Beneficiaries | 832 |
| Number Of Black or African American Beneficiaries | 663 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 897 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 633 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1446 |