| National Provider Identifier [NPI]: | 1285696492 |
| Last Name Of The Provider | SUDARSHAN |
| First Name Of The Provider | SRIRAM |
| 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 | 2101 9TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WICHITA FALLS |
| Zip Code Of The Provider | 763014133 |
| 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 | 112 |
| Number Of Services | 7783 |
| Number Of Medicare Beneficiaries | 2902 |
| Total Submitted Charge Amount | 1566068.24 |
| Total Medicare Allowed Amount | 574700.24 |
| Total Medicare Payment Amount | 426830.13 |
| Total Medicare Standardized Payment Amount | 451081.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 524 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 25832.04 |
| Total Drug Medicare AllowedAmount | 22041.27 |
| Total Drug Medicare PaymentAmount | 16944.97 |
| Total Drug Medicare Standardized Payment Amount | 16944.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 7259 |
| Number Of Medicare Beneficiaries With Medical Services | 2902 |
| Total Medical Submitted Charge Amount | 1540236.2 |
| Total Medical Medicare Allowed Amount | 552658.97 |
| Total Medical Medicare Payment Amount | 409885.16 |
| Total Medical Medicare Standardized Payment Amount | 434136.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 411 |
| Number Of Beneficiaries Age 65 to 74 | 1123 |
| Number Of Beneficiaries Age 75 to 84 | 1012 |
| Number Of Beneficiaries Age Greater 84 | 356 |
| Number Of Female Beneficiaries | 1528 |
| Number Of Male Beneficiaries | 1374 |
| Number Of Non Hispanic White Beneficiaries | 2523 |
| Number Of Black or African American Beneficiaries | 160 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 174 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2397 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 505 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5262 |