| National Provider Identifier [NPI]: | 1982786273 |
| Last Name Of The Provider | KOLA |
| First Name Of The Provider | MANOHAR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 E LAKE SHORE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 625213810 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 6101 |
| Number Of Medicare Beneficiaries | 1992 |
| Total Submitted Charge Amount | 1930083 |
| Total Medicare Allowed Amount | 519405.82 |
| Total Medicare Payment Amount | 383084.28 |
| Total Medicare Standardized Payment Amount | 373281.47 |
| 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 | 58 |
| Number Of Medical Services | 6101 |
| Number Of Medicare Beneficiaries With Medical Services | 1992 |
| Total Medical Submitted Charge Amount | 1930083 |
| Total Medical Medicare Allowed Amount | 519405.82 |
| Total Medical Medicare Payment Amount | 383084.28 |
| Total Medical Medicare Standardized Payment Amount | 373281.47 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 203 |
| Number Of Beneficiaries Age 65 to 74 | 709 |
| Number Of Beneficiaries Age 75 to 84 | 685 |
| Number Of Beneficiaries Age Greater 84 | 395 |
| Number Of Female Beneficiaries | 1095 |
| Number Of Male Beneficiaries | 897 |
| Number Of Non Hispanic White Beneficiaries | 1816 |
| Number Of Black or African American Beneficiaries | 148 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 356 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5515 |