| National Provider Identifier [NPI]: | 1720079395 |
| Last Name Of The Provider | MUKKAMALA |
| First Name Of The Provider | RAGHU |
| 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 | 1722 PINE ST |
| Street Address 2 Of The Provider | SUITE 309 |
| City Of The Provider | MONTGOMERY |
| Zip Code Of The Provider | 361061103 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 10231 |
| Number Of Medicare Beneficiaries | 1146 |
| Total Submitted Charge Amount | 501392.4 |
| Total Medicare Allowed Amount | 352382.26 |
| Total Medicare Payment Amount | 274232.94 |
| Total Medicare Standardized Payment Amount | 295126.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 362 |
| Number Of Medicare Beneficiaries With Drug Services | 313 |
| Total Drug Submitted ChargeAmount | 14788 |
| Total Drug Medicare AllowedAmount | 12043.83 |
| Total Drug Medicare PaymentAmount | 11417.99 |
| Total Drug Medicare Standardized Payment Amount | 11417.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 9869 |
| Number Of Medicare Beneficiaries With Medical Services | 1146 |
| Total Medical Submitted Charge Amount | 486604.4 |
| Total Medical Medicare Allowed Amount | 340338.43 |
| Total Medical Medicare Payment Amount | 262814.95 |
| Total Medical Medicare Standardized Payment Amount | 283708.24 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 465 |
| Number Of Beneficiaries Age 75 to 84 | 389 |
| Number Of Beneficiaries Age Greater 84 | 187 |
| Number Of Female Beneficiaries | 657 |
| Number Of Male Beneficiaries | 489 |
| Number Of Non Hispanic White Beneficiaries | 877 |
| Number Of Black or African American Beneficiaries | 242 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1009 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 137 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.2812 |