| National Provider Identifier [NPI]: | 1871567214 |
| Last Name Of The Provider | KONDRAGUNTA |
| First Name Of The Provider | BUTCHAIAH |
| 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 | 34 MEDICAL PARK BLVD STE G |
| Street Address 2 Of The Provider | SUITE # G |
| City Of The Provider | PETERSBURG |
| Zip Code Of The Provider | 238059283 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 5898 |
| Number Of Medicare Beneficiaries | 262 |
| Total Submitted Charge Amount | 268876 |
| Total Medicare Allowed Amount | 118367.34 |
| Total Medicare Payment Amount | 92966.21 |
| Total Medicare Standardized Payment Amount | 93278.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 31 |
| Number Of Drug Services | 4595 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 125626 |
| Total Drug Medicare AllowedAmount | 45174.24 |
| Total Drug Medicare PaymentAmount | 35403.81 |
| Total Drug Medicare Standardized Payment Amount | 35403.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 1303 |
| Number Of Medicare Beneficiaries With Medical Services | 262 |
| Total Medical Submitted Charge Amount | 143250 |
| Total Medical Medicare Allowed Amount | 73193.1 |
| Total Medical Medicare Payment Amount | 57562.4 |
| Total Medical Medicare Standardized Payment Amount | 57874.68 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 82 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 49 |
| Number Of Female Beneficiaries | 164 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 146 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 181 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 37 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.4531 |