| National Provider Identifier [NPI]: | 1043299746 |
| Last Name Of The Provider | REDDY |
| First Name Of The Provider | BOUYELLA |
| Middle Initial Of The Provider | H |
| 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 | 127 |
| Number Of Services | 17818 |
| Number Of Medicare Beneficiaries | 4563 |
| Total Submitted Charge Amount | 2537037.5 |
| Total Medicare Allowed Amount | 932521.26 |
| Total Medicare Payment Amount | 705997.14 |
| Total Medicare Standardized Payment Amount | 728394.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 7258 |
| Number Of Medicare Beneficiaries With Drug Services | 258 |
| Total Drug Submitted ChargeAmount | 49558.5 |
| Total Drug Medicare AllowedAmount | 43117.79 |
| Total Drug Medicare PaymentAmount | 33592.39 |
| Total Drug Medicare Standardized Payment Amount | 33592.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 10560 |
| Number Of Medicare Beneficiaries With Medical Services | 4563 |
| Total Medical Submitted Charge Amount | 2487479 |
| Total Medical Medicare Allowed Amount | 889403.47 |
| Total Medical Medicare Payment Amount | 672404.75 |
| Total Medical Medicare Standardized Payment Amount | 694802.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 531 |
| Number Of Beneficiaries Age 65 to 74 | 1642 |
| Number Of Beneficiaries Age 75 to 84 | 1522 |
| Number Of Beneficiaries Age Greater 84 | 868 |
| Number Of Female Beneficiaries | 2344 |
| Number Of Male Beneficiaries | 2219 |
| Number Of Non Hispanic White Beneficiaries | 4118 |
| Number Of Black or African American Beneficiaries | 253 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 122 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3816 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 747 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4997 |