| National Provider Identifier [NPI]: | 1063400885 |
| Last Name Of The Provider | JAMES |
| First Name Of The Provider | KODUVATHARA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 225 ABRAHAM FLEXNER WAY |
| Street Address 2 Of The Provider | SUITE 305 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402021882 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 5955 |
| Number Of Medicare Beneficiaries | 2928 |
| Total Submitted Charge Amount | 556484 |
| Total Medicare Allowed Amount | 298474.84 |
| Total Medicare Payment Amount | 231920.27 |
| Total Medicare Standardized Payment Amount | 242519.87 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 654 |
| Number Of Beneficiaries Age 65 to 74 | 1012 |
| Number Of Beneficiaries Age 75 to 84 | 793 |
| Number Of Beneficiaries Age Greater 84 | 469 |
| Number Of Female Beneficiaries | 1569 |
| Number Of Male Beneficiaries | 1359 |
| Number Of Non Hispanic White Beneficiaries | 2465 |
| Number Of Black or African American Beneficiaries | 402 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2073 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 855 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9325 |