| National Provider Identifier [NPI]: | 1689656357 |
| Last Name Of The Provider | BOTLA |
| First Name Of The Provider | VENUGOPAL |
| 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 | 500 S RANCHO DR |
| Street Address 2 Of The Provider | SUITE 12 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064844 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 21154 |
| Number Of Medicare Beneficiaries | 808 |
| Total Submitted Charge Amount | 4903661 |
| Total Medicare Allowed Amount | 1024336.15 |
| Total Medicare Payment Amount | 788018.97 |
| Total Medicare Standardized Payment Amount | 767391.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 18526 |
| Number Of Medicare Beneficiaries With Drug Services | 273 |
| Total Drug Submitted ChargeAmount | 38890 |
| Total Drug Medicare AllowedAmount | 4328.37 |
| Total Drug Medicare PaymentAmount | 3329 |
| Total Drug Medicare Standardized Payment Amount | 3329 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 2628 |
| Number Of Medicare Beneficiaries With Medical Services | 808 |
| Total Medical Submitted Charge Amount | 4864771 |
| Total Medical Medicare Allowed Amount | 1020007.78 |
| Total Medical Medicare Payment Amount | 784689.97 |
| Total Medical Medicare Standardized Payment Amount | 764062.96 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 273 |
| Number Of Beneficiaries Age 65 to 74 | 273 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 349 |
| Number Of Male Beneficiaries | 459 |
| Number Of Non Hispanic White Beneficiaries | 393 |
| Number Of Black or African American Beneficiaries | 195 |
| Number Of AsianPacific Islander Beneficiaries | 70 |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 273 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 67 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 5.3913 |