| National Provider Identifier [NPI]: | 1174530737 |
| Last Name Of The Provider | JAMPALA |
| First Name Of The Provider | SADASIVA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 W UNIVERSITY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHAMPAIGN |
| Zip Code Of The Provider | 618203909 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 186 |
| Number Of Services | 29474 |
| Number Of Medicare Beneficiaries | 2346 |
| Total Submitted Charge Amount | 4386968.48 |
| Total Medicare Allowed Amount | 478395.43 |
| Total Medicare Payment Amount | 357579.19 |
| Total Medicare Standardized Payment Amount | 392530.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 25263 |
| Number Of Medicare Beneficiaries With Drug Services | 453 |
| Total Drug Submitted ChargeAmount | 74756 |
| Total Drug Medicare AllowedAmount | 11731.57 |
| Total Drug Medicare PaymentAmount | 9124.64 |
| Total Drug Medicare Standardized Payment Amount | 9124.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 4211 |
| Number Of Medicare Beneficiaries With Medical Services | 2346 |
| Total Medical Submitted Charge Amount | 4312212.48 |
| Total Medical Medicare Allowed Amount | 466663.86 |
| Total Medical Medicare Payment Amount | 348454.55 |
| Total Medical Medicare Standardized Payment Amount | 383406.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 410 |
| Number Of Beneficiaries Age 65 to 74 | 967 |
| Number Of Beneficiaries Age 75 to 84 | 702 |
| Number Of Beneficiaries Age Greater 84 | 267 |
| Number Of Female Beneficiaries | 1436 |
| Number Of Male Beneficiaries | 910 |
| Number Of Non Hispanic White Beneficiaries | 2096 |
| Number Of Black or African American Beneficiaries | 202 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1928 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 418 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2889 |