| National Provider Identifier [NPI]: | 1053361576 |
| Last Name Of The Provider | KANTAMNENI |
| First Name Of The Provider | RAVINDRANATH |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1540 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363013012 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 9417 |
| Number Of Medicare Beneficiaries | 942 |
| Total Submitted Charge Amount | 920090 |
| Total Medicare Allowed Amount | 615569.14 |
| Total Medicare Payment Amount | 473493.37 |
| Total Medicare Standardized Payment Amount | 499382.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4606 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 78302 |
| Total Drug Medicare AllowedAmount | 52836.36 |
| Total Drug Medicare PaymentAmount | 40255.18 |
| Total Drug Medicare Standardized Payment Amount | 40255.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 4811 |
| Number Of Medicare Beneficiaries With Medical Services | 942 |
| Total Medical Submitted Charge Amount | 841788 |
| Total Medical Medicare Allowed Amount | 562732.78 |
| Total Medical Medicare Payment Amount | 433238.19 |
| Total Medical Medicare Standardized Payment Amount | 459126.9 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 243 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 281 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 478 |
| Number Of Male Beneficiaries | 464 |
| Number Of Non Hispanic White Beneficiaries | 546 |
| Number Of Black or African American Beneficiaries | 380 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 577 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 365 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 3.1852 |