| National Provider Identifier [NPI]: | 1114982881 |
| Last Name Of The Provider | GOLI |
| First Name Of The Provider | VASUDEVA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 817 PRINCETON AVE SW |
| Street Address 2 Of The Provider | PROFESSIONAL BLDG 2 SUITE 202 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352111333 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 7605 |
| Number Of Medicare Beneficiaries | 1463 |
| Total Submitted Charge Amount | 1591882.13 |
| Total Medicare Allowed Amount | 735450.01 |
| Total Medicare Payment Amount | 551445.27 |
| Total Medicare Standardized Payment Amount | 598154 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 641 |
| Number Of Medicare Beneficiaries With Drug Services | 166 |
| Total Drug Submitted ChargeAmount | 63000 |
| Total Drug Medicare AllowedAmount | 33107.22 |
| Total Drug Medicare PaymentAmount | 25126.99 |
| Total Drug Medicare Standardized Payment Amount | 25126.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 6964 |
| Number Of Medicare Beneficiaries With Medical Services | 1463 |
| Total Medical Submitted Charge Amount | 1528882.13 |
| Total Medical Medicare Allowed Amount | 702342.79 |
| Total Medical Medicare Payment Amount | 526318.28 |
| Total Medical Medicare Standardized Payment Amount | 573027.01 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 276 |
| Number Of Beneficiaries Age 65 to 74 | 592 |
| Number Of Beneficiaries Age 75 to 84 | 456 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 815 |
| Number Of Male Beneficiaries | 648 |
| Number Of Non Hispanic White Beneficiaries | 935 |
| Number Of Black or African American Beneficiaries | 515 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1141 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 322 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7686 |