| National Provider Identifier [NPI]: | 1760478853 |
| Last Name Of The Provider | NALLARI |
| First Name Of The Provider | SURYA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 404 10TH ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | DEMOTTE |
| Zip Code Of The Provider | 463109298 |
| 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 | 52 |
| Number Of Services | 10248 |
| Number Of Medicare Beneficiaries | 807 |
| Total Submitted Charge Amount | 771394.58 |
| Total Medicare Allowed Amount | 514642.62 |
| Total Medicare Payment Amount | 377862.44 |
| Total Medicare Standardized Payment Amount | 397240.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 793 |
| Number Of Medicare Beneficiaries With Drug Services | 306 |
| Total Drug Submitted ChargeAmount | 15080 |
| Total Drug Medicare AllowedAmount | 9410.69 |
| Total Drug Medicare PaymentAmount | 8866.95 |
| Total Drug Medicare Standardized Payment Amount | 8866.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 9455 |
| Number Of Medicare Beneficiaries With Medical Services | 807 |
| Total Medical Submitted Charge Amount | 756314.58 |
| Total Medical Medicare Allowed Amount | 505231.93 |
| Total Medical Medicare Payment Amount | 368995.49 |
| Total Medical Medicare Standardized Payment Amount | 388373.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 287 |
| Number Of Beneficiaries Age 75 to 84 | 262 |
| Number Of Beneficiaries Age Greater 84 | 181 |
| Number Of Female Beneficiaries | 443 |
| Number Of Male Beneficiaries | 364 |
| Number Of Non Hispanic White Beneficiaries | 780 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 650 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 157 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5844 |