| National Provider Identifier [NPI]: | 1497734396 |
| Last Name Of The Provider | POTHULA |
| First Name Of The Provider | ASWARTHA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 350 JOHN DEERE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOLINE |
| Zip Code Of The Provider | 612656899 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 16461 |
| Number Of Medicare Beneficiaries | 3262 |
| Total Submitted Charge Amount | 2712896.5 |
| Total Medicare Allowed Amount | 1038602.59 |
| Total Medicare Payment Amount | 782781.87 |
| Total Medicare Standardized Payment Amount | 810400.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 6924 |
| Number Of Medicare Beneficiaries With Drug Services | 235 |
| Total Drug Submitted ChargeAmount | 44666.3 |
| Total Drug Medicare AllowedAmount | 38631.86 |
| Total Drug Medicare PaymentAmount | 29666.72 |
| Total Drug Medicare Standardized Payment Amount | 29666.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 9537 |
| Number Of Medicare Beneficiaries With Medical Services | 3262 |
| Total Medical Submitted Charge Amount | 2668230.2 |
| Total Medical Medicare Allowed Amount | 999970.73 |
| Total Medical Medicare Payment Amount | 753115.15 |
| Total Medical Medicare Standardized Payment Amount | 780733.68 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 272 |
| Number Of Beneficiaries Age 65 to 74 | 1264 |
| Number Of Beneficiaries Age 75 to 84 | 1083 |
| Number Of Beneficiaries Age Greater 84 | 643 |
| Number Of Female Beneficiaries | 1668 |
| Number Of Male Beneficiaries | 1594 |
| Number Of Non Hispanic White Beneficiaries | 2986 |
| Number Of Black or African American Beneficiaries | 146 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 86 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2849 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 413 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4039 |