| National Provider Identifier [NPI]: | 1538159538 |
| Last Name Of The Provider | MUMMADY |
| First Name Of The Provider | PRADYUMNA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 W BAR LE DOC DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | CORPUS CHRISTI |
| Zip Code Of The Provider | 784146157 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 2955 |
| Number Of Medicare Beneficiaries | 539 |
| Total Submitted Charge Amount | 821885.71 |
| Total Medicare Allowed Amount | 254698 |
| Total Medicare Payment Amount | 197194.91 |
| Total Medicare Standardized Payment Amount | 208476.68 |
| 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 | 38 |
| Number Of Medical Services | 2955 |
| Number Of Medicare Beneficiaries With Medical Services | 539 |
| Total Medical Submitted Charge Amount | 821885.71 |
| Total Medical Medicare Allowed Amount | 254698 |
| Total Medical Medicare Payment Amount | 197194.91 |
| Total Medical Medicare Standardized Payment Amount | 208476.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 96 |
| Number Of Beneficiaries Age 65 to 74 | 191 |
| Number Of Beneficiaries Age 75 to 84 | 172 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 290 |
| Number Of Male Beneficiaries | 249 |
| Number Of Non Hispanic White Beneficiaries | 337 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 175 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 384 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 50 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.4753 |