| National Provider Identifier [NPI]: | 1043257413 |
| Last Name Of The Provider | VASIREDDY |
| First Name Of The Provider | RAVIKUMAR |
| 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 | 341 S 33RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUSKOGEE |
| Zip Code Of The Provider | 744015037 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 160470 |
| Number Of Medicare Beneficiaries | 582 |
| Total Submitted Charge Amount | 9022982.78 |
| Total Medicare Allowed Amount | 3434470.34 |
| Total Medicare Payment Amount | 2659777.24 |
| Total Medicare Standardized Payment Amount | 2678694.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 53 |
| Number Of Drug Services | 154482 |
| Number Of Medicare Beneficiaries With Drug Services | 125 |
| Total Drug Submitted ChargeAmount | 7820181.14 |
| Total Drug Medicare AllowedAmount | 3074379.68 |
| Total Drug Medicare PaymentAmount | 2388171.75 |
| Total Drug Medicare Standardized Payment Amount | 2388171.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 5988 |
| Number Of Medicare Beneficiaries With Medical Services | 582 |
| Total Medical Submitted Charge Amount | 1202801.64 |
| Total Medical Medicare Allowed Amount | 360090.66 |
| Total Medical Medicare Payment Amount | 271605.49 |
| Total Medical Medicare Standardized Payment Amount | 290522.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 243 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 378 |
| Number Of Male Beneficiaries | 204 |
| Number Of Non Hispanic White Beneficiaries | 470 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 67 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 451 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7378 |