| National Provider Identifier [NPI]: | 1669444626 |
| Last Name Of The Provider | NANDAM |
| First Name Of The Provider | VENKATESWARA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6388 SILVER STAR RD |
| Street Address 2 Of The Provider | STE# 1C |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328183235 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1213 |
| Number Of Medicare Beneficiaries | 295 |
| Total Submitted Charge Amount | 143354.02 |
| Total Medicare Allowed Amount | 85895.72 |
| Total Medicare Payment Amount | 62548.61 |
| Total Medicare Standardized Payment Amount | 62062.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 2750 |
| Total Drug Medicare AllowedAmount | 869.88 |
| Total Drug Medicare PaymentAmount | 852.39 |
| Total Drug Medicare Standardized Payment Amount | 852.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 1156 |
| Number Of Medicare Beneficiaries With Medical Services | 295 |
| Total Medical Submitted Charge Amount | 140604.02 |
| Total Medical Medicare Allowed Amount | 85025.84 |
| Total Medical Medicare Payment Amount | 61696.22 |
| Total Medical Medicare Standardized Payment Amount | 61209.65 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 78 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 80 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 182 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 69 |
| Number Of Black or African American Beneficiaries | 150 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5471 |