| National Provider Identifier [NPI]: | 1982606893 |
| Last Name Of The Provider | NATTAM |
| First Name Of The Provider | SREENIVASA |
| 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 | 11143 PARKVIEW PLAZA DR |
| Street Address 2 Of The Provider | 100 |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468451727 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 67942 |
| Number Of Medicare Beneficiaries | 722 |
| Total Submitted Charge Amount | 3635088 |
| Total Medicare Allowed Amount | 1594358.19 |
| Total Medicare Payment Amount | 1218219.88 |
| Total Medicare Standardized Payment Amount | 1230690.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 68 |
| Number Of Drug Services | 60518 |
| Number Of Medicare Beneficiaries With Drug Services | 253 |
| Total Drug Submitted ChargeAmount | 3002216 |
| Total Drug Medicare AllowedAmount | 1325306.02 |
| Total Drug Medicare PaymentAmount | 1015323.05 |
| Total Drug Medicare Standardized Payment Amount | 1015323.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 7424 |
| Number Of Medicare Beneficiaries With Medical Services | 722 |
| Total Medical Submitted Charge Amount | 632872 |
| Total Medical Medicare Allowed Amount | 269052.17 |
| Total Medical Medicare Payment Amount | 202896.83 |
| Total Medical Medicare Standardized Payment Amount | 215367.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 317 |
| Number Of Beneficiaries Age 75 to 84 | 219 |
| Number Of Beneficiaries Age Greater 84 | 87 |
| Number Of Female Beneficiaries | 428 |
| Number Of Male Beneficiaries | 294 |
| Number Of Non Hispanic White Beneficiaries | 667 |
| Number Of Black or African American Beneficiaries | 35 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 614 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 108 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 45 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.8326 |