| National Provider Identifier [NPI]: | 1609838333 |
| Last Name Of The Provider | INBA-VAZHVU |
| First Name Of The Provider | MOONGILMADUGU |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6507 PROFESSIONAL PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERDALE |
| Zip Code Of The Provider | 302744941 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 2438 |
| Number Of Medicare Beneficiaries | 1073 |
| Total Submitted Charge Amount | 465879.89 |
| Total Medicare Allowed Amount | 144616.39 |
| Total Medicare Payment Amount | 109845.43 |
| Total Medicare Standardized Payment Amount | 116229.13 |
| 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 | 32 |
| Number Of Medical Services | 2438 |
| Number Of Medicare Beneficiaries With Medical Services | 1073 |
| Total Medical Submitted Charge Amount | 465879.89 |
| Total Medical Medicare Allowed Amount | 144616.39 |
| Total Medical Medicare Payment Amount | 109845.43 |
| Total Medical Medicare Standardized Payment Amount | 116229.13 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 252 |
| Number Of Beneficiaries Age 65 to 74 | 382 |
| Number Of Beneficiaries Age 75 to 84 | 288 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 598 |
| Number Of Male Beneficiaries | 475 |
| Number Of Non Hispanic White Beneficiaries | 581 |
| Number Of Black or African American Beneficiaries | 437 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 735 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.1513 |