| National Provider Identifier [NPI]: | 1437129236 |
| Last Name Of The Provider | KAVIKONDALA |
| First Name Of The Provider | VIJAYA |
| 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 | 14131 MIDWAY RD |
| Street Address 2 Of The Provider | SUITE 620 |
| City Of The Provider | ADDISON |
| Zip Code Of The Provider | 750013623 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 2536 |
| Number Of Medicare Beneficiaries | 610 |
| Total Submitted Charge Amount | 544243 |
| Total Medicare Allowed Amount | 268115.93 |
| Total Medicare Payment Amount | 207363.03 |
| Total Medicare Standardized Payment Amount | 216778.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 2536 |
| Number Of Medicare Beneficiaries With Medical Services | 610 |
| Total Medical Submitted Charge Amount | 544243 |
| Total Medical Medicare Allowed Amount | 268115.93 |
| Total Medical Medicare Payment Amount | 207363.03 |
| Total Medical Medicare Standardized Payment Amount | 216778.68 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 196 |
| Number Of Beneficiaries Age Greater 84 | 164 |
| Number Of Female Beneficiaries | 376 |
| Number Of Male Beneficiaries | 234 |
| Number Of Non Hispanic White Beneficiaries | 493 |
| Number Of Black or African American Beneficiaries | 50 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 440 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 170 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 42 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.2512 |