| National Provider Identifier [NPI]: | 1740303429 |
| Last Name Of The Provider | DONEPUDI |
| First Name Of The Provider | JYOTSNA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 816 W CANNON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT WORTH |
| Zip Code Of The Provider | 761043146 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 169 |
| Number Of Services | 5700 |
| Number Of Medicare Beneficiaries | 4027 |
| Total Submitted Charge Amount | 495188 |
| Total Medicare Allowed Amount | 158336.28 |
| Total Medicare Payment Amount | 114161.42 |
| Total Medicare Standardized Payment Amount | 119297.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 5700 |
| Number Of Medicare Beneficiaries With Medical Services | 4027 |
| Total Medical Submitted Charge Amount | 495188 |
| Total Medical Medicare Allowed Amount | 158336.28 |
| Total Medical Medicare Payment Amount | 114161.42 |
| Total Medical Medicare Standardized Payment Amount | 119297.22 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 859 |
| Number Of Beneficiaries Age 65 to 74 | 1626 |
| Number Of Beneficiaries Age 75 to 84 | 1121 |
| Number Of Beneficiaries Age Greater 84 | 421 |
| Number Of Female Beneficiaries | 2447 |
| Number Of Male Beneficiaries | 1580 |
| Number Of Non Hispanic White Beneficiaries | 3156 |
| Number Of Black or African American Beneficiaries | 572 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 248 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3008 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1019 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3698 |