| National Provider Identifier [NPI]: | 1649486994 |
| Last Name Of The Provider | GUMIDYALA |
| First Name Of The Provider | KRISHNA |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 TOWER RD NE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300609404 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Unknown Physician Specialty Code |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 1851 |
| Number Of Medicare Beneficiaries | 484 |
| Total Submitted Charge Amount | 806298.65 |
| Total Medicare Allowed Amount | 205952.32 |
| Total Medicare Payment Amount | 155714.29 |
| Total Medicare Standardized Payment Amount | 158927.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 205 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1495 |
| Total Drug Medicare AllowedAmount | 402.35 |
| Total Drug Medicare PaymentAmount | 301.1 |
| Total Drug Medicare Standardized Payment Amount | 301.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 1646 |
| Number Of Medicare Beneficiaries With Medical Services | 484 |
| Total Medical Submitted Charge Amount | 804803.65 |
| Total Medical Medicare Allowed Amount | 205549.97 |
| Total Medical Medicare Payment Amount | 155413.19 |
| Total Medical Medicare Standardized Payment Amount | 158626.07 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 205 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 300 |
| Number Of Male Beneficiaries | 184 |
| Number Of Non Hispanic White Beneficiaries | 395 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 420 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2817 |