| National Provider Identifier [NPI]: | 1356347876 |
| Last Name Of The Provider | GOUD |
| First Name Of The Provider | GUNDUMALLA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7500 AUBURN RD # 2300 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CONCORD TWP |
| Zip Code Of The Provider | 440779176 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 4191 |
| Number Of Medicare Beneficiaries | 948 |
| Total Submitted Charge Amount | 336705 |
| Total Medicare Allowed Amount | 222515.91 |
| Total Medicare Payment Amount | 161459.52 |
| Total Medicare Standardized Payment Amount | 152941.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 109 |
| Total Drug Submitted ChargeAmount | 6628 |
| Total Drug Medicare AllowedAmount | 4593.86 |
| Total Drug Medicare PaymentAmount | 4468.99 |
| Total Drug Medicare Standardized Payment Amount | 4468.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 4070 |
| Number Of Medicare Beneficiaries With Medical Services | 948 |
| Total Medical Submitted Charge Amount | 330077 |
| Total Medical Medicare Allowed Amount | 217922.05 |
| Total Medical Medicare Payment Amount | 156990.53 |
| Total Medical Medicare Standardized Payment Amount | 148472.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 325 |
| Number Of Beneficiaries Age 75 to 84 | 245 |
| Number Of Beneficiaries Age Greater 84 | 222 |
| Number Of Female Beneficiaries | 532 |
| Number Of Male Beneficiaries | 416 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 704 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 244 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8978 |