| National Provider Identifier [NPI]: | 1316920242 |
| Last Name Of The Provider | SRIVATHSAN |
| First Name Of The Provider | KOMANDOOR |
| 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 | 5777 E MAYO BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850544502 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Electrophysiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 103 |
| Number Of Services | 4298 |
| Number Of Medicare Beneficiaries | 2073 |
| Total Submitted Charge Amount | 414552.54 |
| Total Medicare Allowed Amount | 311857.18 |
| Total Medicare Payment Amount | 228961.92 |
| Total Medicare Standardized Payment Amount | 247160.27 |
| 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 | 103 |
| Number Of Medical Services | 4298 |
| Number Of Medicare Beneficiaries With Medical Services | 2073 |
| Total Medical Submitted Charge Amount | 414552.54 |
| Total Medical Medicare Allowed Amount | 311857.18 |
| Total Medical Medicare Payment Amount | 228961.92 |
| Total Medical Medicare Standardized Payment Amount | 247160.27 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 595 |
| Number Of Beneficiaries Age 75 to 84 | 883 |
| Number Of Beneficiaries Age Greater 84 | 519 |
| Number Of Female Beneficiaries | 801 |
| Number Of Male Beneficiaries | 1272 |
| Number Of Non Hispanic White Beneficiaries | 1955 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2031 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 42 |
| Percent Of With Atrial Fibrillation | 47 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6479 |