| National Provider Identifier [NPI]: | 1568490118 |
| Last Name Of The Provider | KURICHETY |
| First Name Of The Provider | KIRAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2604 SAINT MICHAEL DR |
| Street Address 2 Of The Provider | SUITE 345 |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755032379 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 5138 |
| Number Of Medicare Beneficiaries | 1581 |
| Total Submitted Charge Amount | 514611.53 |
| Total Medicare Allowed Amount | 491215.66 |
| Total Medicare Payment Amount | 370600.88 |
| Total Medicare Standardized Payment Amount | 389639.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 332 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 18735.84 |
| Total Drug Medicare AllowedAmount | 17581.11 |
| Total Drug Medicare PaymentAmount | 13415.61 |
| Total Drug Medicare Standardized Payment Amount | 13415.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 4806 |
| Number Of Medicare Beneficiaries With Medical Services | 1581 |
| Total Medical Submitted Charge Amount | 495875.69 |
| Total Medical Medicare Allowed Amount | 473634.55 |
| Total Medical Medicare Payment Amount | 357185.27 |
| Total Medical Medicare Standardized Payment Amount | 376223.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 621 |
| Number Of Beneficiaries Age 75 to 84 | 527 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 834 |
| Number Of Male Beneficiaries | 747 |
| Number Of Non Hispanic White Beneficiaries | 1293 |
| Number Of Black or African American Beneficiaries | 255 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1247 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 334 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6315 |