| National Provider Identifier [NPI]: | 1184622078 |
| Last Name Of The Provider | PUCHALAPALLI |
| First Name Of The Provider | SUBBAREDDY |
| 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 | 2250 WABASH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TERRE HAUTE |
| Zip Code Of The Provider | 478073317 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2583 |
| Number Of Medicare Beneficiaries | 479 |
| Total Submitted Charge Amount | 228421 |
| Total Medicare Allowed Amount | 154270.38 |
| Total Medicare Payment Amount | 107635.5 |
| Total Medicare Standardized Payment Amount | 113556.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 222 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 4560 |
| Total Drug Medicare AllowedAmount | 1355.38 |
| Total Drug Medicare PaymentAmount | 1178.63 |
| Total Drug Medicare Standardized Payment Amount | 1178.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 2361 |
| Number Of Medicare Beneficiaries With Medical Services | 479 |
| Total Medical Submitted Charge Amount | 223861 |
| Total Medical Medicare Allowed Amount | 152915 |
| Total Medical Medicare Payment Amount | 106456.87 |
| Total Medical Medicare Standardized Payment Amount | 112377.45 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 119 |
| Number Of Beneficiaries Age 65 to 74 | 201 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 431 |
| Number Of Black or African American Beneficiaries | 30 |
| 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 | 325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 154 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3996 |