| National Provider Identifier [NPI]: | 1518903681 |
| Last Name Of The Provider | GUNIGANTI |
| First Name Of The Provider | PRABHAKAR |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1303 MOUND STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | NACOGDOCHES |
| Zip Code Of The Provider | 75961 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 118 |
| Number Of Services | 11614 |
| Number Of Medicare Beneficiaries | 885 |
| Total Submitted Charge Amount | 2046908 |
| Total Medicare Allowed Amount | 1039312.74 |
| Total Medicare Payment Amount | 784461.04 |
| Total Medicare Standardized Payment Amount | 824270.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 544 |
| Number Of Medicare Beneficiaries With Drug Services | 290 |
| Total Drug Submitted ChargeAmount | 19211 |
| Total Drug Medicare AllowedAmount | 4157.68 |
| Total Drug Medicare PaymentAmount | 3696.07 |
| Total Drug Medicare Standardized Payment Amount | 3696.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 11070 |
| Number Of Medicare Beneficiaries With Medical Services | 885 |
| Total Medical Submitted Charge Amount | 2027697 |
| Total Medical Medicare Allowed Amount | 1035155.06 |
| Total Medical Medicare Payment Amount | 780764.97 |
| Total Medical Medicare Standardized Payment Amount | 820574.26 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 205 |
| Number Of Beneficiaries Age 65 to 74 | 324 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 427 |
| Number Of Male Beneficiaries | 458 |
| Number Of Non Hispanic White Beneficiaries | 616 |
| Number Of Black or African American Beneficiaries | 225 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 550 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 335 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 66 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.835 |