| National Provider Identifier [NPI]: | 1295949030 |
| Last Name Of The Provider | MADALA |
| First Name Of The Provider | MOHAN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2134 HAMPTON PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | OKEMOS |
| Zip Code Of The Provider | 488643691 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 3883 |
| Number Of Medicare Beneficiaries | 1456 |
| Total Submitted Charge Amount | 454299 |
| Total Medicare Allowed Amount | 288634.84 |
| Total Medicare Payment Amount | 225255.55 |
| Total Medicare Standardized Payment Amount | 231675.71 |
| 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 | 70 |
| Number Of Medical Services | 3883 |
| Number Of Medicare Beneficiaries With Medical Services | 1456 |
| Total Medical Submitted Charge Amount | 454299 |
| Total Medical Medicare Allowed Amount | 288634.84 |
| Total Medical Medicare Payment Amount | 225255.55 |
| Total Medical Medicare Standardized Payment Amount | 231675.71 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 242 |
| Number Of Beneficiaries Age 65 to 74 | 564 |
| Number Of Beneficiaries Age 75 to 84 | 427 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 752 |
| Number Of Male Beneficiaries | 704 |
| Number Of Non Hispanic White Beneficiaries | 1206 |
| Number Of Black or African American Beneficiaries | 169 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 307 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7704 |