| National Provider Identifier [NPI]: | 1528036118 |
| Last Name Of The Provider | KOTHAPALLI |
| First Name Of The Provider | SRINIVASA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2501 JIMMY JOHNSON BOULEVARD |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | PORT ARTHUR |
| Zip Code Of The Provider | 77640 |
| 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 | 88 |
| Number Of Services | 8361 |
| Number Of Medicare Beneficiaries | 1272 |
| Total Submitted Charge Amount | 3543783 |
| Total Medicare Allowed Amount | 1466361.76 |
| Total Medicare Payment Amount | 1106052.27 |
| Total Medicare Standardized Payment Amount | 1143966.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2051 |
| Number Of Medicare Beneficiaries With Drug Services | 491 |
| Total Drug Submitted ChargeAmount | 133150 |
| Total Drug Medicare AllowedAmount | 108411.21 |
| Total Drug Medicare PaymentAmount | 82288.46 |
| Total Drug Medicare Standardized Payment Amount | 82288.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 6310 |
| Number Of Medicare Beneficiaries With Medical Services | 1272 |
| Total Medical Submitted Charge Amount | 3410633 |
| Total Medical Medicare Allowed Amount | 1357950.55 |
| Total Medical Medicare Payment Amount | 1023763.81 |
| Total Medical Medicare Standardized Payment Amount | 1061678.34 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 166 |
| Number Of Beneficiaries Age 65 to 74 | 548 |
| Number Of Beneficiaries Age 75 to 84 | 382 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 692 |
| Number Of Male Beneficiaries | 580 |
| Number Of Non Hispanic White Beneficiaries | 937 |
| Number Of Black or African American Beneficiaries | 247 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 63 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1069 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 203 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2675 |