| National Provider Identifier [NPI]: | 1053316547 |
| Last Name Of The Provider | GUDIMETLA |
| First Name Of The Provider | SREENIVAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 RIVER NORTH BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | STEPHENVILLE |
| Zip Code Of The Provider | 764011803 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 3160 |
| Number Of Medicare Beneficiaries | 1274 |
| Total Submitted Charge Amount | 702145.17 |
| Total Medicare Allowed Amount | 266642.95 |
| Total Medicare Payment Amount | 198546.73 |
| Total Medicare Standardized Payment Amount | 203961.67 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
| Total Medical Medicare Payment Amount | |
| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 411 |
| Number Of Beneficiaries Age 75 to 84 | 431 |
| Number Of Beneficiaries Age Greater 84 | 282 |
| Number Of Female Beneficiaries | 671 |
| Number Of Male Beneficiaries | 603 |
| Number Of Non Hispanic White Beneficiaries | 1058 |
| Number Of Black or African American Beneficiaries | 122 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 76 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1014 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 260 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.0371 |