| National Provider Identifier [NPI]: | 1659355824 |
| Last Name Of The Provider | TEGULAPALLE |
| First Name Of The Provider | LAKSHMI |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 W CALIFORNIA BLVD |
| Street Address 2 Of The Provider | RADIOLOGY DEPT. |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911053010 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 4881 |
| Number Of Medicare Beneficiaries | 2330 |
| Total Submitted Charge Amount | 880381 |
| Total Medicare Allowed Amount | 376035.55 |
| Total Medicare Payment Amount | 333285.97 |
| Total Medicare Standardized Payment Amount | 297320.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 433 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 4711 |
| Total Drug Medicare AllowedAmount | 666.44 |
| Total Drug Medicare PaymentAmount | 522.51 |
| Total Drug Medicare Standardized Payment Amount | 522.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 4448 |
| Number Of Medicare Beneficiaries With Medical Services | 2330 |
| Total Medical Submitted Charge Amount | 875670 |
| Total Medical Medicare Allowed Amount | 375369.11 |
| Total Medical Medicare Payment Amount | 332763.46 |
| Total Medical Medicare Standardized Payment Amount | 296797.51 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 190 |
| Number Of Beneficiaries Age 65 to 74 | 1146 |
| Number Of Beneficiaries Age 75 to 84 | 689 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 2035 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 1479 |
| Number Of Black or African American Beneficiaries | 164 |
| Number Of AsianPacific Islander Beneficiaries | 257 |
| Number Of Hispanic Beneficiaries | 343 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1816 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 514 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3029 |