| National Provider Identifier [NPI]: | 1205034998 |
| Last Name Of The Provider | DAVULURI |
| First Name Of The Provider | SRIKANTH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 N WALL ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | KANKAKEE |
| Zip Code Of The Provider | 609012942 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2462 |
| Number Of Medicare Beneficiaries | 857 |
| Total Submitted Charge Amount | 622437 |
| Total Medicare Allowed Amount | 242931.03 |
| Total Medicare Payment Amount | 184738.35 |
| Total Medicare Standardized Payment Amount | 181168.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 17 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 211 |
| Total Drug Medicare AllowedAmount | 15.67 |
| Total Drug Medicare PaymentAmount | 10.32 |
| Total Drug Medicare Standardized Payment Amount | 10.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2445 |
| Number Of Medicare Beneficiaries With Medical Services | 857 |
| Total Medical Submitted Charge Amount | 622226 |
| Total Medical Medicare Allowed Amount | 242915.36 |
| Total Medical Medicare Payment Amount | 184728.03 |
| Total Medical Medicare Standardized Payment Amount | 181158.54 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 463 |
| Number Of Male Beneficiaries | 394 |
| Number Of Non Hispanic White Beneficiaries | 612 |
| Number Of Black or African American Beneficiaries | 158 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 62 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 533 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 324 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 59 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4389 |