| National Provider Identifier [NPI]: | 1881843662 |
| Last Name Of The Provider | DONURU |
| First Name Of The Provider | ACHALA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 S 11TH ST |
| Street Address 2 Of The Provider | SUITE 3390 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191074824 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 11747 |
| Number Of Medicare Beneficiaries | 3219 |
| Total Submitted Charge Amount | 1292603.67 |
| Total Medicare Allowed Amount | 152827.08 |
| Total Medicare Payment Amount | 111965.88 |
| Total Medicare Standardized Payment Amount | 107690.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 7033 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 16457.22 |
| Total Drug Medicare AllowedAmount | 1308.87 |
| Total Drug Medicare PaymentAmount | 1026.24 |
| Total Drug Medicare Standardized Payment Amount | 1026.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 4714 |
| Number Of Medicare Beneficiaries With Medical Services | 3219 |
| Total Medical Submitted Charge Amount | 1276146.45 |
| Total Medical Medicare Allowed Amount | 151518.21 |
| Total Medical Medicare Payment Amount | 110939.64 |
| Total Medical Medicare Standardized Payment Amount | 106663.98 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 668 |
| Number Of Beneficiaries Age 65 to 74 | 1346 |
| Number Of Beneficiaries Age 75 to 84 | 794 |
| Number Of Beneficiaries Age Greater 84 | 411 |
| Number Of Female Beneficiaries | 1667 |
| Number Of Male Beneficiaries | 1552 |
| Number Of Non Hispanic White Beneficiaries | 2211 |
| Number Of Black or African American Beneficiaries | 679 |
| Number Of AsianPacific Islander Beneficiaries | 212 |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2253 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 966 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.2438 |