| National Provider Identifier [NPI]: | 1811050644 |
| Last Name Of The Provider | TELLA |
| First Name Of The Provider | MANJULA |
| 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 | 2735 N CLARKSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREMONT |
| Zip Code Of The Provider | 680257717 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 5543 |
| Number Of Medicare Beneficiaries | 981 |
| Total Submitted Charge Amount | 936444 |
| Total Medicare Allowed Amount | 454053.8 |
| Total Medicare Payment Amount | 328515.12 |
| Total Medicare Standardized Payment Amount | 354136.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1953 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 15226 |
| Total Drug Medicare AllowedAmount | 10607.06 |
| Total Drug Medicare PaymentAmount | 8306.33 |
| Total Drug Medicare Standardized Payment Amount | 8306.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 3590 |
| Number Of Medicare Beneficiaries With Medical Services | 981 |
| Total Medical Submitted Charge Amount | 921218 |
| Total Medical Medicare Allowed Amount | 443446.74 |
| Total Medical Medicare Payment Amount | 320208.79 |
| Total Medical Medicare Standardized Payment Amount | 345829.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 294 |
| Number Of Beneficiaries Age 75 to 84 | 315 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 579 |
| Number Of Male Beneficiaries | 402 |
| Number Of Non Hispanic White Beneficiaries | 959 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 728 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 253 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.2637 |