| National Provider Identifier [NPI]: | 1861676025 |
| Last Name Of The Provider | VUNDAMATI |
| First Name Of The Provider | VENKATA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 205 S WABASHA ST |
| Street Address 2 Of The Provider | MAIL STOP 31300A - HEALTHPARTNERS ST. PAUL CLINIC |
| City Of The Provider | ST. PAUL |
| Zip Code Of The Provider | 551071805 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 648 |
| Number Of Medicare Beneficiaries | 105 |
| Total Submitted Charge Amount | 45432 |
| Total Medicare Allowed Amount | 16719.43 |
| Total Medicare Payment Amount | 11583.64 |
| Total Medicare Standardized Payment Amount | 11860.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 353 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1134 |
| Total Drug Medicare AllowedAmount | 315.92 |
| Total Drug Medicare PaymentAmount | 278.26 |
| Total Drug Medicare Standardized Payment Amount | 278.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 295 |
| Number Of Medicare Beneficiaries With Medical Services | 105 |
| Total Medical Submitted Charge Amount | 44298 |
| Total Medical Medicare Allowed Amount | 16403.51 |
| Total Medical Medicare Payment Amount | 11305.38 |
| Total Medical Medicare Standardized Payment Amount | 11582.38 |
| Average Age Of Beneficiaries | 55 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 39 |
| Number Of Non Hispanic White Beneficiaries | 56 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 33 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 48 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 30 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2166 |