| National Provider Identifier [NPI]: | 1649214990 |
| Last Name Of The Provider | PODDER |
| First Name Of The Provider | UTTAM |
| 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 | 4305 ATLANTA HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTGOMERY |
| Zip Code Of The Provider | 361093101 |
| 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 | 97 |
| Number Of Services | 8934 |
| Number Of Medicare Beneficiaries | 1095 |
| Total Submitted Charge Amount | 297365 |
| Total Medicare Allowed Amount | 172495.56 |
| Total Medicare Payment Amount | 119914.05 |
| Total Medicare Standardized Payment Amount | 136438.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 5041 |
| Number Of Medicare Beneficiaries With Drug Services | 586 |
| Total Drug Submitted ChargeAmount | 54897 |
| Total Drug Medicare AllowedAmount | 6342.63 |
| Total Drug Medicare PaymentAmount | 4435.59 |
| Total Drug Medicare Standardized Payment Amount | 4435.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 3893 |
| Number Of Medicare Beneficiaries With Medical Services | 1095 |
| Total Medical Submitted Charge Amount | 242468 |
| Total Medical Medicare Allowed Amount | 166152.93 |
| Total Medical Medicare Payment Amount | 115478.46 |
| Total Medical Medicare Standardized Payment Amount | 132002.86 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 152 |
| Number Of Beneficiaries Age 65 to 74 | 523 |
| Number Of Beneficiaries Age 75 to 84 | 290 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 678 |
| Number Of Male Beneficiaries | 417 |
| Number Of Non Hispanic White Beneficiaries | 836 |
| Number Of Black or African American Beneficiaries | 228 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1036 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9209 |