| National Provider Identifier [NPI]: | 1477556868 |
| Last Name Of The Provider | KESAVA |
| First Name Of The Provider | PRABHAKAR |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12700 PARK CENTRAL DR |
| Street Address 2 Of The Provider | STE 430 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752511527 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 2529 |
| Number Of Medicare Beneficiaries | 1725 |
| Total Submitted Charge Amount | 547210 |
| Total Medicare Allowed Amount | 153177.39 |
| Total Medicare Payment Amount | 117918.79 |
| Total Medicare Standardized Payment Amount | 119638.04 |
| 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 | 109 |
| Number Of Medical Services | 2529 |
| Number Of Medicare Beneficiaries With Medical Services | 1725 |
| Total Medical Submitted Charge Amount | 547210 |
| Total Medical Medicare Allowed Amount | 153177.39 |
| Total Medical Medicare Payment Amount | 117918.79 |
| Total Medical Medicare Standardized Payment Amount | 119638.04 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 326 |
| Number Of Beneficiaries Age 65 to 74 | 673 |
| Number Of Beneficiaries Age 75 to 84 | 467 |
| Number Of Beneficiaries Age Greater 84 | 259 |
| Number Of Female Beneficiaries | 1008 |
| Number Of Male Beneficiaries | 717 |
| Number Of Non Hispanic White Beneficiaries | 1318 |
| Number Of Black or African American Beneficiaries | 222 |
| Number Of AsianPacific Islander Beneficiaries | 47 |
| Number Of Hispanic Beneficiaries | 109 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1351 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 374 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.722 |