| National Provider Identifier [NPI]: | 1417117839 |
| Last Name Of The Provider | KOTHA |
| First Name Of The Provider | ROSHAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8860 CENTER DR STE 400 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LA MESA |
| Zip Code Of The Provider | 919427003 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 654 |
| Number Of Medicare Beneficiaries | 185 |
| Total Submitted Charge Amount | 67789.43 |
| Total Medicare Allowed Amount | 58855.71 |
| Total Medicare Payment Amount | 45485.05 |
| Total Medicare Standardized Payment Amount | 43528.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 133 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 675 |
| Total Drug Medicare AllowedAmount | 438.79 |
| Total Drug Medicare PaymentAmount | 328.88 |
| Total Drug Medicare Standardized Payment Amount | 328.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 521 |
| Number Of Medicare Beneficiaries With Medical Services | 185 |
| Total Medical Submitted Charge Amount | 67114.43 |
| Total Medical Medicare Allowed Amount | 58416.92 |
| Total Medical Medicare Payment Amount | 45156.17 |
| Total Medical Medicare Standardized Payment Amount | 43199.32 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 55 |
| Number Of Non Hispanic White Beneficiaries | 124 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 29 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4391 |