| National Provider Identifier [NPI]: | 1487628194 |
| Last Name Of The Provider | TUMMALA |
| First Name Of The Provider | AJAYA |
| 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 | 2727 HEARNE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711033931 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 4724 |
| Number Of Medicare Beneficiaries | 1239 |
| Total Submitted Charge Amount | 803518 |
| Total Medicare Allowed Amount | 326018.96 |
| Total Medicare Payment Amount | 240305.73 |
| Total Medicare Standardized Payment Amount | 253560.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 656 |
| Number Of Medicare Beneficiaries With Drug Services | 164 |
| Total Drug Submitted ChargeAmount | 82000 |
| Total Drug Medicare AllowedAmount | 34731.36 |
| Total Drug Medicare PaymentAmount | 24926.34 |
| Total Drug Medicare Standardized Payment Amount | 24926.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 4068 |
| Number Of Medicare Beneficiaries With Medical Services | 1239 |
| Total Medical Submitted Charge Amount | 721518 |
| Total Medical Medicare Allowed Amount | 291287.6 |
| Total Medical Medicare Payment Amount | 215379.39 |
| Total Medical Medicare Standardized Payment Amount | 228634.58 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 189 |
| Number Of Beneficiaries Age 65 to 74 | 459 |
| Number Of Beneficiaries Age 75 to 84 | 437 |
| Number Of Beneficiaries Age Greater 84 | 154 |
| Number Of Female Beneficiaries | 654 |
| Number Of Male Beneficiaries | 585 |
| Number Of Non Hispanic White Beneficiaries | 772 |
| Number Of Black or African American Beneficiaries | 444 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 912 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 327 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.8829 |