| National Provider Identifier [NPI]: | 1528214970 |
| Last Name Of The Provider | KOTA |
| First Name Of The Provider | GOPI |
| 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 | 1825 LOGAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERLOO |
| Zip Code Of The Provider | 507031916 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 238 |
| Number Of Services | 11194 |
| Number Of Medicare Beneficiaries | 3118 |
| Total Submitted Charge Amount | 1210588.5 |
| Total Medicare Allowed Amount | 281786.3 |
| Total Medicare Payment Amount | 217061.19 |
| Total Medicare Standardized Payment Amount | 229655.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 5391 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 12502.5 |
| Total Drug Medicare AllowedAmount | 1590.83 |
| Total Drug Medicare PaymentAmount | 1247.13 |
| Total Drug Medicare Standardized Payment Amount | 1247.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 232 |
| Number Of Medical Services | 5803 |
| Number Of Medicare Beneficiaries With Medical Services | 3117 |
| Total Medical Submitted Charge Amount | 1198086 |
| Total Medical Medicare Allowed Amount | 280195.47 |
| Total Medical Medicare Payment Amount | 215814.06 |
| Total Medical Medicare Standardized Payment Amount | 228407.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 463 |
| Number Of Beneficiaries Age 65 to 74 | 1150 |
| Number Of Beneficiaries Age 75 to 84 | 952 |
| Number Of Beneficiaries Age Greater 84 | 553 |
| Number Of Female Beneficiaries | 1684 |
| Number Of Male Beneficiaries | 1434 |
| Number Of Non Hispanic White Beneficiaries | 2802 |
| Number Of Black or African American Beneficiaries | 262 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 634 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6409 |