| National Provider Identifier [NPI]: | 1194767806 |
| Last Name Of The Provider | DULAM |
| First Name Of The Provider | VIKRAMADITYA |
| 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 | 140 JEFFERSON DAVIS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NATCHEZ |
| Zip Code Of The Provider | 391205104 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 15822 |
| Number Of Medicare Beneficiaries | 2748 |
| Total Submitted Charge Amount | 3812232.5 |
| Total Medicare Allowed Amount | 1238379.13 |
| Total Medicare Payment Amount | 928934.77 |
| Total Medicare Standardized Payment Amount | 1027517.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3270 |
| Number Of Medicare Beneficiaries With Drug Services | 690 |
| Total Drug Submitted ChargeAmount | 19845.5 |
| Total Drug Medicare AllowedAmount | 2683.08 |
| Total Drug Medicare PaymentAmount | 2087.92 |
| Total Drug Medicare Standardized Payment Amount | 2087.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 12552 |
| Number Of Medicare Beneficiaries With Medical Services | 2748 |
| Total Medical Submitted Charge Amount | 3792387 |
| Total Medical Medicare Allowed Amount | 1235696.05 |
| Total Medical Medicare Payment Amount | 926846.85 |
| Total Medical Medicare Standardized Payment Amount | 1025429.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 611 |
| Number Of Beneficiaries Age 65 to 74 | 905 |
| Number Of Beneficiaries Age 75 to 84 | 805 |
| Number Of Beneficiaries Age Greater 84 | 427 |
| Number Of Female Beneficiaries | 1612 |
| Number Of Male Beneficiaries | 1136 |
| Number Of Non Hispanic White Beneficiaries | 1295 |
| Number Of Black or African American Beneficiaries | 1436 |
| 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 | 1352 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1396 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5789 |