| National Provider Identifier [NPI]: | 1972500932 |
| Last Name Of The Provider | VIVEKANANTHAN |
| First Name Of The Provider | KRISHNAMOORTHY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13325 HARGRAVE RD STE 100 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770704540 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Peripheral Vascular Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 3614 |
| Number Of Medicare Beneficiaries | 1383 |
| Total Submitted Charge Amount | 785685 |
| Total Medicare Allowed Amount | 288160.76 |
| Total Medicare Payment Amount | 221608.3 |
| Total Medicare Standardized Payment Amount | 220706.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 108 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 8010 |
| Total Drug Medicare AllowedAmount | 5302.54 |
| Total Drug Medicare PaymentAmount | 4118.12 |
| Total Drug Medicare Standardized Payment Amount | 4118.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 3506 |
| Number Of Medicare Beneficiaries With Medical Services | 1383 |
| Total Medical Submitted Charge Amount | 777675 |
| Total Medical Medicare Allowed Amount | 282858.22 |
| Total Medical Medicare Payment Amount | 217490.18 |
| Total Medical Medicare Standardized Payment Amount | 216588.38 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 296 |
| Number Of Beneficiaries Age 65 to 74 | 467 |
| Number Of Beneficiaries Age 75 to 84 | 393 |
| Number Of Beneficiaries Age Greater 84 | 227 |
| Number Of Female Beneficiaries | 804 |
| Number Of Male Beneficiaries | 579 |
| Number Of Non Hispanic White Beneficiaries | 798 |
| Number Of Black or African American Beneficiaries | 353 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 149 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 925 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 458 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 2.8549 |