| National Provider Identifier [NPI]: | 1528246071 |
| Last Name Of The Provider | GOTTIMUKKULA |
| First Name Of The Provider | RAJASHREE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3691 RUTGER ST STE 100 |
| Street Address 2 Of The Provider | DRUMMOND HALL |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631102515 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 32963 |
| Number Of Medicare Beneficiaries | 714 |
| Total Submitted Charge Amount | 757568 |
| Total Medicare Allowed Amount | 307417.01 |
| Total Medicare Payment Amount | 238875.71 |
| Total Medicare Standardized Payment Amount | 243524.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 30203 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 151910 |
| Total Drug Medicare AllowedAmount | 22730.1 |
| Total Drug Medicare PaymentAmount | 17819.41 |
| Total Drug Medicare Standardized Payment Amount | 17819.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 2760 |
| Number Of Medicare Beneficiaries With Medical Services | 714 |
| Total Medical Submitted Charge Amount | 605658 |
| Total Medical Medicare Allowed Amount | 284686.91 |
| Total Medical Medicare Payment Amount | 221056.3 |
| Total Medical Medicare Standardized Payment Amount | 225704.95 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 224 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 114 |
| Number Of Female Beneficiaries | 352 |
| Number Of Male Beneficiaries | 362 |
| Number Of Non Hispanic White Beneficiaries | 603 |
| 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 | 483 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 231 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 58 |
| Percent Of With Chronic Kidney Disease | 70 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 52 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 3.5007 |