| National Provider Identifier [NPI]: | 1407830698 |
| Last Name Of The Provider | MANDA |
| First Name Of The Provider | RAMANUJA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD FACC FCCP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6308 8TH AVE |
| Street Address 2 Of The Provider | STE 3060 |
| City Of The Provider | KENOSHA |
| Zip Code Of The Provider | 531435082 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 3993 |
| Number Of Medicare Beneficiaries | 1500 |
| Total Submitted Charge Amount | 1141343 |
| Total Medicare Allowed Amount | 151235.37 |
| Total Medicare Payment Amount | 112054.38 |
| Total Medicare Standardized Payment Amount | 115323.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 3993 |
| Number Of Medicare Beneficiaries With Medical Services | 1500 |
| Total Medical Submitted Charge Amount | 1141343 |
| Total Medical Medicare Allowed Amount | 151235.37 |
| Total Medical Medicare Payment Amount | 112054.38 |
| Total Medical Medicare Standardized Payment Amount | 115323.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 300 |
| Number Of Beneficiaries Age 65 to 74 | 445 |
| Number Of Beneficiaries Age 75 to 84 | 459 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 858 |
| Number Of Male Beneficiaries | 642 |
| Number Of Non Hispanic White Beneficiaries | 1293 |
| Number Of Black or African American Beneficiaries | 112 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1077 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 423 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5843 |