| National Provider Identifier [NPI]: | 1164512836 |
| Last Name Of The Provider | KOTLABA |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 158 EXECUTIVE DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DANVILLE |
| Zip Code Of The Provider | 245414100 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 4521 |
| Number Of Medicare Beneficiaries | 983 |
| Total Submitted Charge Amount | 780978 |
| Total Medicare Allowed Amount | 395156.54 |
| Total Medicare Payment Amount | 296613.59 |
| Total Medicare Standardized Payment Amount | 303813.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 220 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 12313 |
| Total Drug Medicare AllowedAmount | 11244.79 |
| Total Drug Medicare PaymentAmount | 8768.15 |
| Total Drug Medicare Standardized Payment Amount | 8768.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 4301 |
| Number Of Medicare Beneficiaries With Medical Services | 983 |
| Total Medical Submitted Charge Amount | 768665 |
| Total Medical Medicare Allowed Amount | 383911.75 |
| Total Medical Medicare Payment Amount | 287845.44 |
| Total Medical Medicare Standardized Payment Amount | 295045.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 402 |
| Number Of Beneficiaries Age 75 to 84 | 291 |
| Number Of Beneficiaries Age Greater 84 | 175 |
| Number Of Female Beneficiaries | 506 |
| Number Of Male Beneficiaries | 477 |
| Number Of Non Hispanic White Beneficiaries | 776 |
| Number Of Black or African American Beneficiaries | 191 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 777 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 206 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4749 |