| National Provider Identifier [NPI]: | 1144289539 |
| Last Name Of The Provider | PANCHOLY |
| First Name Of The Provider | AJAY |
| 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 | 2700 UNIVERSITY SQUARE DRIVE |
| Street Address 2 Of The Provider | RADIOLOGY ASSOCIATES OF TAMPA |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336125513 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 201 |
| Number Of Services | 18565 |
| Number Of Medicare Beneficiaries | 5911 |
| Total Submitted Charge Amount | 1767318 |
| Total Medicare Allowed Amount | 532104.01 |
| Total Medicare Payment Amount | 420844.4 |
| Total Medicare Standardized Payment Amount | 431874.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 9579 |
| Number Of Medicare Beneficiaries With Drug Services | 191 |
| Total Drug Submitted ChargeAmount | 17497 |
| Total Drug Medicare AllowedAmount | 3549.01 |
| Total Drug Medicare PaymentAmount | 2685.5 |
| Total Drug Medicare Standardized Payment Amount | 2685.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 198 |
| Number Of Medical Services | 8986 |
| Number Of Medicare Beneficiaries With Medical Services | 5910 |
| Total Medical Submitted Charge Amount | 1749821 |
| Total Medical Medicare Allowed Amount | 528555 |
| Total Medical Medicare Payment Amount | 418158.9 |
| Total Medical Medicare Standardized Payment Amount | 429189.46 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 921 |
| Number Of Beneficiaries Age 65 to 74 | 2424 |
| Number Of Beneficiaries Age 75 to 84 | 1772 |
| Number Of Beneficiaries Age Greater 84 | 794 |
| Number Of Female Beneficiaries | 3750 |
| Number Of Male Beneficiaries | 2161 |
| Number Of Non Hispanic White Beneficiaries | 4681 |
| Number Of Black or African American Beneficiaries | 504 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 550 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 89 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4683 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1228 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6765 |