| National Provider Identifier [NPI]: | 1245252733 |
| Last Name Of The Provider | KOTTAPALLI |
| First Name Of The Provider | MAHESH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2727 BOLTON BOONE DR |
| Street Address 2 Of The Provider | 109 |
| City Of The Provider | DESOTO |
| Zip Code Of The Provider | 751152019 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 4430 |
| Number Of Medicare Beneficiaries | 892 |
| Total Submitted Charge Amount | 512362 |
| Total Medicare Allowed Amount | 400197.62 |
| Total Medicare Payment Amount | 309528.16 |
| Total Medicare Standardized Payment Amount | 329362.84 |
| 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 | 18 |
| Number Of Medical Services | 4430 |
| Number Of Medicare Beneficiaries With Medical Services | 892 |
| Total Medical Submitted Charge Amount | 512362 |
| Total Medical Medicare Allowed Amount | 400197.62 |
| Total Medical Medicare Payment Amount | 309528.16 |
| Total Medical Medicare Standardized Payment Amount | 329362.84 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 260 |
| Number Of Beneficiaries Age 65 to 74 | 298 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 131 |
| Number Of Female Beneficiaries | 491 |
| Number Of Male Beneficiaries | 401 |
| Number Of Non Hispanic White Beneficiaries | 440 |
| Number Of Black or African American Beneficiaries | 351 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 81 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 473 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 419 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 42 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 67 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 67 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 3.9844 |