| National Provider Identifier [NPI]: | 1063583359 |
| Last Name Of The Provider | MARLA |
| First Name Of The Provider | RAMMOHAN |
| 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 | 2570 24TH ST |
| Street Address 2 Of The Provider | SUITE 127 |
| City Of The Provider | ROCK ISLAND |
| Zip Code Of The Provider | 612015394 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Thoracic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 274 |
| Number Of Services | 8387 |
| Number Of Medicare Beneficiaries | 530 |
| Total Submitted Charge Amount | 2274633.8 |
| Total Medicare Allowed Amount | 406138.37 |
| Total Medicare Payment Amount | 314393.09 |
| Total Medicare Standardized Payment Amount | 340783.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5475 |
| Number Of Medicare Beneficiaries With Drug Services | 45 |
| Total Drug Submitted ChargeAmount | 8322.5 |
| Total Drug Medicare AllowedAmount | 1107.65 |
| Total Drug Medicare PaymentAmount | 868.3 |
| Total Drug Medicare Standardized Payment Amount | 868.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 271 |
| Number Of Medical Services | 2912 |
| Number Of Medicare Beneficiaries With Medical Services | 530 |
| Total Medical Submitted Charge Amount | 2266311.3 |
| Total Medical Medicare Allowed Amount | 405030.72 |
| Total Medical Medicare Payment Amount | 313524.79 |
| Total Medical Medicare Standardized Payment Amount | 339914.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 82 |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 177 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 252 |
| Number Of Male Beneficiaries | 278 |
| Number Of Non Hispanic White Beneficiaries | 508 |
| 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 | 417 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.0244 |