| National Provider Identifier [NPI]: | 1588760979 |
| Last Name Of The Provider | JONNALA |
| First Name Of The Provider | PRAVEEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10833 LE CONTE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900953075 |
| 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 | 125 |
| Number Of Services | 4153 |
| Number Of Medicare Beneficiaries | 2182 |
| Total Submitted Charge Amount | 306963 |
| Total Medicare Allowed Amount | 145727.94 |
| Total Medicare Payment Amount | 107565.8 |
| Total Medicare Standardized Payment Amount | 103231.4 |
| 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 | 125 |
| Number Of Medical Services | 4153 |
| Number Of Medicare Beneficiaries With Medical Services | 2182 |
| Total Medical Submitted Charge Amount | 306963 |
| Total Medical Medicare Allowed Amount | 145727.94 |
| Total Medical Medicare Payment Amount | 107565.8 |
| Total Medical Medicare Standardized Payment Amount | 103231.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 448 |
| Number Of Beneficiaries Age 65 to 74 | 652 |
| Number Of Beneficiaries Age 75 to 84 | 630 |
| Number Of Beneficiaries Age Greater 84 | 452 |
| Number Of Female Beneficiaries | 1249 |
| Number Of Male Beneficiaries | 933 |
| Number Of Non Hispanic White Beneficiaries | 1014 |
| Number Of Black or African American Beneficiaries | 412 |
| Number Of AsianPacific Islander Beneficiaries | 269 |
| Number Of Hispanic Beneficiaries | 435 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1080 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1102 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 24 |
| Average HCC Risk Score Of Beneficiaries | 2.5397 |