| National Provider Identifier [NPI]: | 1871527028 |
| Last Name Of The Provider | DEVABHAKTUNI |
| First Name Of The Provider | PRASAD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3560 DELAWARE ST STE 209 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEAUMONT |
| Zip Code Of The Provider | 777063059 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 4178 |
| Number Of Medicare Beneficiaries | 2772 |
| Total Submitted Charge Amount | 534628 |
| Total Medicare Allowed Amount | 127471.81 |
| Total Medicare Payment Amount | 97742.82 |
| Total Medicare Standardized Payment Amount | 102476.32 |
| 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 | 165 |
| Number Of Medical Services | 4178 |
| Number Of Medicare Beneficiaries With Medical Services | 2772 |
| Total Medical Submitted Charge Amount | 534628 |
| Total Medical Medicare Allowed Amount | 127471.81 |
| Total Medical Medicare Payment Amount | 97742.82 |
| Total Medical Medicare Standardized Payment Amount | 102476.32 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 614 |
| Number Of Beneficiaries Age 65 to 74 | 960 |
| Number Of Beneficiaries Age 75 to 84 | 811 |
| Number Of Beneficiaries Age Greater 84 | 387 |
| Number Of Female Beneficiaries | 1727 |
| Number Of Male Beneficiaries | 1045 |
| Number Of Non Hispanic White Beneficiaries | 2046 |
| Number Of Black or African American Beneficiaries | 635 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1934 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 838 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8588 |