| National Provider Identifier [NPI]: | 1902936578 |
| Last Name Of The Provider | DIVAKARUNI |
| First Name Of The Provider | SHASHIDHAR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1730 45TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 463213915 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 8547 |
| Number Of Medicare Beneficiaries | 3861 |
| Total Submitted Charge Amount | 1628960 |
| Total Medicare Allowed Amount | 484196.37 |
| Total Medicare Payment Amount | 361950.22 |
| Total Medicare Standardized Payment Amount | 371659.4 |
| 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 | 95 |
| Number Of Medical Services | 8547 |
| Number Of Medicare Beneficiaries With Medical Services | 3861 |
| Total Medical Submitted Charge Amount | 1628960 |
| Total Medical Medicare Allowed Amount | 484196.37 |
| Total Medical Medicare Payment Amount | 361950.22 |
| Total Medical Medicare Standardized Payment Amount | 371659.4 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 488 |
| Number Of Beneficiaries Age 65 to 74 | 1256 |
| Number Of Beneficiaries Age 75 to 84 | 1281 |
| Number Of Beneficiaries Age Greater 84 | 836 |
| Number Of Female Beneficiaries | 2164 |
| Number Of Male Beneficiaries | 1697 |
| Number Of Non Hispanic White Beneficiaries | 2971 |
| Number Of Black or African American Beneficiaries | 495 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 354 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 668 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9619 |