| National Provider Identifier [NPI]: | 1174525729 |
| Last Name Of The Provider | GUDUGUNTLA |
| First Name Of The Provider | VAMSHIDHAR |
| 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 | 25195 KELLY RD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ROSEVILLE |
| Zip Code Of The Provider | 480664909 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 7358 |
| Number Of Medicare Beneficiaries | 2050 |
| Total Submitted Charge Amount | 1183502.88 |
| Total Medicare Allowed Amount | 632614.87 |
| Total Medicare Payment Amount | 481183.92 |
| Total Medicare Standardized Payment Amount | 471998.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 803 |
| Number Of Medicare Beneficiaries With Drug Services | 171 |
| Total Drug Submitted ChargeAmount | 37200 |
| Total Drug Medicare AllowedAmount | 16853.99 |
| Total Drug Medicare PaymentAmount | 13211.85 |
| Total Drug Medicare Standardized Payment Amount | 13211.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 6555 |
| Number Of Medicare Beneficiaries With Medical Services | 2050 |
| Total Medical Submitted Charge Amount | 1146302.88 |
| Total Medical Medicare Allowed Amount | 615760.88 |
| Total Medical Medicare Payment Amount | 467972.07 |
| Total Medical Medicare Standardized Payment Amount | 458786.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 391 |
| Number Of Beneficiaries Age 65 to 74 | 644 |
| Number Of Beneficiaries Age 75 to 84 | 615 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1137 |
| Number Of Male Beneficiaries | 913 |
| Number Of Non Hispanic White Beneficiaries | 1231 |
| Number Of Black or African American Beneficiaries | 768 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1488 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.6045 |