| National Provider Identifier [NPI]: | 1629044821 |
| Last Name Of The Provider | MALLIDI |
| First Name Of The Provider | PADMAJA |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2013 JEFFERSON ST SW |
| Street Address 2 Of The Provider | SECOND FLOOR |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 240142419 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 159 |
| Number Of Services | 135481 |
| Number Of Medicare Beneficiaries | 858 |
| Total Submitted Charge Amount | 6607136.92 |
| Total Medicare Allowed Amount | 1873875.02 |
| Total Medicare Payment Amount | 1459103.41 |
| Total Medicare Standardized Payment Amount | 1458005.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 76 |
| Number Of Drug Services | 124739 |
| Number Of Medicare Beneficiaries With Drug Services | 270 |
| Total Drug Submitted ChargeAmount | 5090917.92 |
| Total Drug Medicare AllowedAmount | 1390291.71 |
| Total Drug Medicare PaymentAmount | 1082561.16 |
| Total Drug Medicare Standardized Payment Amount | 1082561.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 10742 |
| Number Of Medicare Beneficiaries With Medical Services | 858 |
| Total Medical Submitted Charge Amount | 1516219 |
| Total Medical Medicare Allowed Amount | 483583.31 |
| Total Medical Medicare Payment Amount | 376542.25 |
| Total Medical Medicare Standardized Payment Amount | 375444.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 129 |
| Number Of Beneficiaries Age 65 to 74 | 370 |
| Number Of Beneficiaries Age 75 to 84 | 261 |
| Number Of Beneficiaries Age Greater 84 | 98 |
| Number Of Female Beneficiaries | 472 |
| Number Of Male Beneficiaries | 386 |
| Number Of Non Hispanic White Beneficiaries | 735 |
| Number Of Black or African American Beneficiaries | 104 |
| 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 | 711 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 42 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 2.0658 |