| National Provider Identifier [NPI]: | 1952340887 |
| Last Name Of The Provider | VODAPALLY |
| First Name Of The Provider | MOHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D.,DABPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1423 CHAPEL ST STE 1A |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW HAVEN |
| Zip Code Of The Provider | 065114411 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 4144 |
| Number Of Medicare Beneficiaries | 355 |
| Total Submitted Charge Amount | 1042065.19 |
| Total Medicare Allowed Amount | 305780.08 |
| Total Medicare Payment Amount | 226223.08 |
| Total Medicare Standardized Payment Amount | 209288.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 597 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 13309 |
| Total Drug Medicare AllowedAmount | 2717.96 |
| Total Drug Medicare PaymentAmount | 2117.9 |
| Total Drug Medicare Standardized Payment Amount | 2117.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3547 |
| Number Of Medicare Beneficiaries With Medical Services | 355 |
| Total Medical Submitted Charge Amount | 1028756.19 |
| Total Medical Medicare Allowed Amount | 303062.12 |
| Total Medical Medicare Payment Amount | 224105.18 |
| Total Medical Medicare Standardized Payment Amount | 207170.29 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 222 |
| Number Of Male Beneficiaries | 133 |
| Number Of Non Hispanic White Beneficiaries | 259 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 194 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7941 |