| National Provider Identifier [NPI]: | 1962587295 |
| Last Name Of The Provider | KODALI |
| First Name Of The Provider | RAVI |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2213 CHERRY ST |
| Street Address 2 Of The Provider | ATTN: MRG ASSOCIATES, LLC - RADIOLOGY DEPT. |
| City Of The Provider | TOLEDO |
| Zip Code Of The Provider | 436082603 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 228 |
| Number Of Services | 3935 |
| Number Of Medicare Beneficiaries | 2380 |
| Total Submitted Charge Amount | 330860 |
| Total Medicare Allowed Amount | 154786.58 |
| Total Medicare Payment Amount | 118711.96 |
| Total Medicare Standardized Payment Amount | 124170.21 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 759 |
| Number Of Beneficiaries Age 65 to 74 | 769 |
| Number Of Beneficiaries Age 75 to 84 | 520 |
| Number Of Beneficiaries Age Greater 84 | 332 |
| Number Of Female Beneficiaries | 1329 |
| Number Of Male Beneficiaries | 1051 |
| Number Of Non Hispanic White Beneficiaries | 1880 |
| Number Of Black or African American Beneficiaries | 344 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1469 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 911 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0045 |