| National Provider Identifier [NPI]: | 1720184849 |
| Last Name Of The Provider | RAMANUJA |
| First Name Of The Provider | SRINIVASAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1421 PREMIER DR |
| Street Address 2 Of The Provider | MANKATO CLINIC WICKERSHAM |
| City Of The Provider | MANKATO |
| Zip Code Of The Provider | 56001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 1677 |
| Number Of Medicare Beneficiaries | 71 |
| Total Submitted Charge Amount | 53573.6 |
| Total Medicare Allowed Amount | 23120.4 |
| Total Medicare Payment Amount | 17261.12 |
| Total Medicare Standardized Payment Amount | 17482.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 481.68 |
| Total Drug Medicare AllowedAmount | 371.48 |
| Total Drug Medicare PaymentAmount | 364.03 |
| Total Drug Medicare Standardized Payment Amount | 364.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1665 |
| Number Of Medicare Beneficiaries With Medical Services | 71 |
| Total Medical Submitted Charge Amount | 53091.92 |
| Total Medical Medicare Allowed Amount | 22748.92 |
| Total Medical Medicare Payment Amount | 16897.09 |
| Total Medical Medicare Standardized Payment Amount | 17118 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 51 |
| Number Of Male Beneficiaries | 20 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 48 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0321 |