| National Provider Identifier [NPI]: | 1043414626 |
| Last Name Of The Provider | MUMMADI |
| First Name Of The Provider | SRINIVAS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MBBS |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 364 SE 8TH AVE STE 301A |
| Street Address 2 Of The Provider | |
| City Of The Provider | HILLSBORO |
| Zip Code Of The Provider | 971235273 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 443 |
| Number Of Medicare Beneficiaries | 178 |
| Total Submitted Charge Amount | 150717 |
| Total Medicare Allowed Amount | 30584.95 |
| Total Medicare Payment Amount | 22401.31 |
| Total Medicare Standardized Payment Amount | 22977.13 |
| 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 | 39 |
| Number Of Medical Services | 443 |
| Number Of Medicare Beneficiaries With Medical Services | 178 |
| Total Medical Submitted Charge Amount | 150717 |
| Total Medical Medicare Allowed Amount | 30584.95 |
| Total Medical Medicare Payment Amount | 22401.31 |
| Total Medical Medicare Standardized Payment Amount | 22977.13 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 80 |
| Number Of Beneficiaries Age 75 to 84 | 44 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 148 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 30 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5632 |