| National Provider Identifier [NPI]: | 1578766796 |
| Last Name Of The Provider | VAKKALANKA |
| First Name Of The Provider | BHANU |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 407 E VERNON AVENUE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | NORMAL |
| Zip Code Of The Provider | 617613813 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 66290 |
| Number Of Medicare Beneficiaries | 228 |
| Total Submitted Charge Amount | 2448377 |
| Total Medicare Allowed Amount | 1099813.07 |
| Total Medicare Payment Amount | 858549.15 |
| Total Medicare Standardized Payment Amount | 859209.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 47 |
| Number Of Drug Services | 59796 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 1527272 |
| Total Drug Medicare AllowedAmount | 817450.89 |
| Total Drug Medicare PaymentAmount | 635409.22 |
| Total Drug Medicare Standardized Payment Amount | 635409.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 6494 |
| Number Of Medicare Beneficiaries With Medical Services | 228 |
| Total Medical Submitted Charge Amount | 921105 |
| Total Medical Medicare Allowed Amount | 282362.18 |
| Total Medical Medicare Payment Amount | 223139.93 |
| Total Medical Medicare Standardized Payment Amount | 223800.1 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 134 |
| Number Of Male Beneficiaries | 94 |
| Number Of Non Hispanic White Beneficiaries | 217 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 188 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 41 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7233 |