| National Provider Identifier [NPI]: | 1548263999 |
| Last Name Of The Provider | BETHALA |
| First Name Of The Provider | VASANTH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1051 GAUSE BLVD |
| Street Address 2 Of The Provider | STE 320 |
| City Of The Provider | SLIDELL |
| Zip Code Of The Provider | 704582988 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 5545 |
| Number Of Medicare Beneficiaries | 1398 |
| Total Submitted Charge Amount | 1247882 |
| Total Medicare Allowed Amount | 409748.66 |
| Total Medicare Payment Amount | 300887.83 |
| Total Medicare Standardized Payment Amount | 323394.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 532 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 57335 |
| Total Drug Medicare AllowedAmount | 24037.36 |
| Total Drug Medicare PaymentAmount | 18481.5 |
| Total Drug Medicare Standardized Payment Amount | 18481.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 5013 |
| Number Of Medicare Beneficiaries With Medical Services | 1398 |
| Total Medical Submitted Charge Amount | 1190547 |
| Total Medical Medicare Allowed Amount | 385711.3 |
| Total Medical Medicare Payment Amount | 282406.33 |
| Total Medical Medicare Standardized Payment Amount | 304913.26 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 173 |
| Number Of Beneficiaries Age 65 to 74 | 613 |
| Number Of Beneficiaries Age 75 to 84 | 421 |
| Number Of Beneficiaries Age Greater 84 | 191 |
| Number Of Female Beneficiaries | 759 |
| Number Of Male Beneficiaries | 639 |
| Number Of Non Hispanic White Beneficiaries | 1209 |
| Number Of Black or African American Beneficiaries | 132 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 257 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8282 |