| National Provider Identifier [NPI]: | 1912994971 |
| Last Name Of The Provider | VRINDAVANAM |
| First Name Of The Provider | NANDAGOPAL |
| 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 | 235 N BREIEL BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 450423807 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 54116 |
| Number Of Medicare Beneficiaries | 276 |
| Total Submitted Charge Amount | 2198062.8 |
| Total Medicare Allowed Amount | 1090123.04 |
| Total Medicare Payment Amount | 843397.23 |
| Total Medicare Standardized Payment Amount | 844049.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 53 |
| Number Of Drug Services | 51286 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 1857491.06 |
| Total Drug Medicare AllowedAmount | 925807.32 |
| Total Drug Medicare PaymentAmount | 720291.76 |
| Total Drug Medicare Standardized Payment Amount | 720291.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 2830 |
| Number Of Medicare Beneficiaries With Medical Services | 276 |
| Total Medical Submitted Charge Amount | 340571.74 |
| Total Medical Medicare Allowed Amount | 164315.72 |
| Total Medical Medicare Payment Amount | 123105.47 |
| Total Medical Medicare Standardized Payment Amount | 123757.44 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 143 |
| Number Of Non Hispanic White Beneficiaries | 248 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 220 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 40 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.2359 |