| National Provider Identifier [NPI]: | 1396734653 |
| Last Name Of The Provider | FOTEDAR |
| First Name Of The Provider | ANIL |
| 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 | 700 SHADOW LN |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064158 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 3693 |
| Number Of Medicare Beneficiaries | 1289 |
| Total Submitted Charge Amount | 589740 |
| Total Medicare Allowed Amount | 260933.19 |
| Total Medicare Payment Amount | 194811.57 |
| Total Medicare Standardized Payment Amount | 193740.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 312 |
| Number Of Medicare Beneficiaries With Drug Services | 71 |
| Total Drug Submitted ChargeAmount | 16055 |
| Total Drug Medicare AllowedAmount | 260.09 |
| Total Drug Medicare PaymentAmount | 196.5 |
| Total Drug Medicare Standardized Payment Amount | 196.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 3381 |
| Number Of Medicare Beneficiaries With Medical Services | 1289 |
| Total Medical Submitted Charge Amount | 573685 |
| Total Medical Medicare Allowed Amount | 260673.1 |
| Total Medical Medicare Payment Amount | 194615.07 |
| Total Medical Medicare Standardized Payment Amount | 193544.03 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 228 |
| Number Of Beneficiaries Age 65 to 74 | 478 |
| Number Of Beneficiaries Age 75 to 84 | 399 |
| Number Of Beneficiaries Age Greater 84 | 184 |
| Number Of Female Beneficiaries | 677 |
| Number Of Male Beneficiaries | 612 |
| Number Of Non Hispanic White Beneficiaries | 869 |
| Number Of Black or African American Beneficiaries | 169 |
| Number Of AsianPacific Islander Beneficiaries | 96 |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 911 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 378 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.2183 |