| National Provider Identifier [NPI]: | 1841492733 |
| Last Name Of The Provider | KOTWAL |
| First Name Of The Provider | SHAVETA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21170 ASHBY PONDS BLVD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | ASHBURN |
| Zip Code Of The Provider | 20147 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 6029 |
| Number Of Medicare Beneficiaries | 651 |
| Total Submitted Charge Amount | 303944.2 |
| Total Medicare Allowed Amount | 303334.54 |
| Total Medicare Payment Amount | 231072.76 |
| Total Medicare Standardized Payment Amount | 235160.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 496 |
| Number Of Medicare Beneficiaries With Drug Services | 476 |
| Total Drug Submitted ChargeAmount | 16026.31 |
| Total Drug Medicare AllowedAmount | 15997.13 |
| Total Drug Medicare PaymentAmount | 15669.82 |
| Total Drug Medicare Standardized Payment Amount | 15669.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 5533 |
| Number Of Medicare Beneficiaries With Medical Services | 651 |
| Total Medical Submitted Charge Amount | 287917.89 |
| Total Medical Medicare Allowed Amount | 287337.41 |
| Total Medical Medicare Payment Amount | 215402.94 |
| Total Medical Medicare Standardized Payment Amount | 219490.55 |
| Average Age Of Beneficiaries | 84 |
| Number Of Beneficiaries Age Less65 | 0 |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 314 |
| Number Of Beneficiaries Age Greater 84 | 286 |
| Number Of Female Beneficiaries | 423 |
| Number Of Male Beneficiaries | 228 |
| Number Of Non Hispanic White Beneficiaries | 634 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 651 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 31 |
| 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 | 1.2179 |