| National Provider Identifier [NPI]: | 1447332457 |
| Last Name Of The Provider | PANCHAMUKHI |
| First Name Of The Provider | VARADENDRA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 409 W OAK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARBONDALE |
| Zip Code Of The Provider | 629011414 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 7601 |
| Number Of Medicare Beneficiaries | 2852 |
| Total Submitted Charge Amount | 2476017 |
| Total Medicare Allowed Amount | 664168.49 |
| Total Medicare Payment Amount | 491357.21 |
| Total Medicare Standardized Payment Amount | 496924.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 7601 |
| Number Of Medicare Beneficiaries With Medical Services | 2852 |
| Total Medical Submitted Charge Amount | 2476017 |
| Total Medical Medicare Allowed Amount | 664168.49 |
| Total Medical Medicare Payment Amount | 491357.21 |
| Total Medical Medicare Standardized Payment Amount | 496924.88 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 596 |
| Number Of Beneficiaries Age 65 to 74 | 1057 |
| Number Of Beneficiaries Age 75 to 84 | 815 |
| Number Of Beneficiaries Age Greater 84 | 384 |
| Number Of Female Beneficiaries | 1510 |
| Number Of Male Beneficiaries | 1342 |
| Number Of Non Hispanic White Beneficiaries | 2654 |
| Number Of Black or African American Beneficiaries | 158 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1855 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 997 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6739 |