| National Provider Identifier [NPI]: | 1790892016 |
| Last Name Of The Provider | SUBBU |
| First Name Of The Provider | MAHESH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2150 W 24TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | YUMA |
| Zip Code Of The Provider | 853646122 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 3293 |
| Number Of Medicare Beneficiaries | 780 |
| Total Submitted Charge Amount | 529892.71 |
| Total Medicare Allowed Amount | 228543.87 |
| Total Medicare Payment Amount | 165313.1 |
| Total Medicare Standardized Payment Amount | 162040.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 464 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 12380.05 |
| Total Drug Medicare AllowedAmount | 5477.64 |
| Total Drug Medicare PaymentAmount | 4926.02 |
| Total Drug Medicare Standardized Payment Amount | 4926.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 2829 |
| Number Of Medicare Beneficiaries With Medical Services | 780 |
| Total Medical Submitted Charge Amount | 517512.66 |
| Total Medical Medicare Allowed Amount | 223066.23 |
| Total Medical Medicare Payment Amount | 160387.08 |
| Total Medical Medicare Standardized Payment Amount | 157114.8 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 365 |
| Number Of Beneficiaries Age 75 to 84 | 293 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 394 |
| Number Of Male Beneficiaries | 386 |
| Number Of Non Hispanic White Beneficiaries | 709 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 738 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1543 |