Physician

Pratap Reddy Tummala, MD

According to 2025 Medicare claims, Pratap Tummala, MD (NPI: 1730187816) practices rheumatology in the Sherman-Denison, TX market, with the plurality of this provider's patient population coming from Grayson, TX. This provider's primary affiliated billing organization is ARTHRITIS AND RHEUMATISM CENTER P.A. (NPI: 1427188416; TIN: 710947746) and primary practice location at 75090-1779. Tummala is affiliated with the CoreHealth Alliance LLC (ACO ID: A5645), participating under the MSSP model.

Tummala's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 833 traditional Medicare patients, billed 32,167 HCPCS/CPT codes, and received $336,027 in Medicare payments. The top billing code was 99213 (Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more). Part D data shows 5,428 prescription claims across 828 beneficiaries totaling $2,842,283 in drug costs, led by Humira(Cf) Pen (Adalimumab). DME data shows 12 claims. Open Payments data shows 9 records totaling $148. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has changed little. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $674,909 to $2,842,283. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	993	29,252	$458,191
2016	1,026	31,167	$460,767
2017	1,028	32,480	$501,259
2018	1,084	30,552	$537,594
2019	1,142	32,050	$541,237
2020	1,100	28,077	$464,271
2021	1,000	24,977	$419,150
2022	989	35,939	$416,326
2023	936	42,042	$396,422
2024	833	32,167	$336,027

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	657	5,332	$674,909
2016	726	5,659	$857,036
2017	771	5,870	$1,081,257
2018	827	6,172	$1,071,385
2019	859	6,483	$1,349,053
2020	884	6,678	$1,817,775
2021	835	5,979	$1,773,598
2022	874	6,032	$2,545,830
2023	854	5,875	$3,467,687
2024	828	5,428	$2,842,283

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	13	13	$11,950
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	N/R	11	$451
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	13	$532
2024	N/R	12	$296

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	642	1,545	$59
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	173	343	$35
73130	X-ray of hand, minimum of 3 views	211	407	$25
36415	Insertion of needle into vein for collection of blood sample	454	947	$8
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	317	2,357	$1

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Humira(Cf) Pen	Adalimumab	87	2,524	$629,180
Enbrel Sureclick	Etanercept	74	2,520	$608,626
Humira(Cf)	Adalimumab	33	890	$260,276
Cosentyx Syringe	Secukinumab	21	598	$157,919
Humira Pen	Adalimumab	16	644	$157,139

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
K0003	Lightweight wheelchair	Y	N/R	12	$296

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	9	$148	Amgen Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Pratap Reddy Tummala, MD?

Tedicare shows public-source Medicare data for Pratap Reddy Tummala, MD (NPI 1730187816), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Pratap Reddy Tummala, MD have ACO affiliation data?

Pratap Reddy Tummala, MD is shown with ACO affiliation data for CoreHealth Alliance LLC (MSSP, ACO ID A5645).

What billing organization is linked to Pratap Reddy Tummala, MD?

Pratap Reddy Tummala, MD is linked to ARTHRITIS AND RHEUMATISM CENTER P.A. (billing NPI 1427188416) in the available physician profile data.

Does Pratap Reddy Tummala, MD have Open Payments data?

Pratap Reddy Tummala, MD has 9 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.