| National Provider Identifier [NPI]: | 1609195833 |
| Last Name Of The Provider | HANUMANTHAPPA |
| First Name Of The Provider | NANDHEESHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3221 TAMIAMI TRL |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT CHARLOTTE |
| Zip Code Of The Provider | 339528002 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 19194 |
| Number Of Medicare Beneficiaries | 1138 |
| Total Submitted Charge Amount | 855725 |
| Total Medicare Allowed Amount | 539976.84 |
| Total Medicare Payment Amount | 418430.75 |
| Total Medicare Standardized Payment Amount | 417306.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 13941 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 44480 |
| Total Drug Medicare AllowedAmount | 22836.85 |
| Total Drug Medicare PaymentAmount | 17701.35 |
| Total Drug Medicare Standardized Payment Amount | 17701.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 5253 |
| Number Of Medicare Beneficiaries With Medical Services | 1138 |
| Total Medical Submitted Charge Amount | 811245 |
| Total Medical Medicare Allowed Amount | 517139.99 |
| Total Medical Medicare Payment Amount | 400729.4 |
| Total Medical Medicare Standardized Payment Amount | 399605.07 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 309 |
| Number Of Beneficiaries Age 75 to 84 | 397 |
| Number Of Beneficiaries Age Greater 84 | 300 |
| Number Of Female Beneficiaries | 502 |
| Number Of Male Beneficiaries | 636 |
| Number Of Non Hispanic White Beneficiaries | 1027 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 869 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 269 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 63 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 3.3784 |