| National Provider Identifier [NPI]: | 1588667901 |
| Last Name Of The Provider | TELUKUNTLA |
| First Name Of The Provider | KOTESHWAR |
| 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 | 401 MANATEE AVE E |
| Street Address 2 Of The Provider | STE B |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342081143 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 232937 |
| Number Of Medicare Beneficiaries | 898 |
| Total Submitted Charge Amount | 6450627 |
| Total Medicare Allowed Amount | 2423535.61 |
| Total Medicare Payment Amount | 1901250.19 |
| Total Medicare Standardized Payment Amount | 1897284.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 67 |
| Number Of Drug Services | 219579 |
| Number Of Medicare Beneficiaries With Drug Services | 350 |
| Total Drug Submitted ChargeAmount | 5325810 |
| Total Drug Medicare AllowedAmount | 2003388.53 |
| Total Drug Medicare PaymentAmount | 1568000.84 |
| Total Drug Medicare Standardized Payment Amount | 1568000.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 13358 |
| Number Of Medicare Beneficiaries With Medical Services | 897 |
| Total Medical Submitted Charge Amount | 1124817 |
| Total Medical Medicare Allowed Amount | 420147.08 |
| Total Medical Medicare Payment Amount | 333249.35 |
| Total Medical Medicare Standardized Payment Amount | 329283.27 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 334 |
| Number Of Beneficiaries Age 75 to 84 | 330 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 512 |
| Number Of Male Beneficiaries | 386 |
| Number Of Non Hispanic White Beneficiaries | 785 |
| Number Of Black or African American Beneficiaries | 65 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 748 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 39 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.0641 |