| National Provider Identifier [NPI]: | 1568432508 |
| Last Name Of The Provider | BODAGALA |
| First Name Of The Provider | SIVA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12951 SOUTH FWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770471923 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 4926 |
| Number Of Medicare Beneficiaries | 2409 |
| Total Submitted Charge Amount | 381305 |
| Total Medicare Allowed Amount | 118537.79 |
| Total Medicare Payment Amount | 88219.93 |
| Total Medicare Standardized Payment Amount | 90731.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 680 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 3800 |
| Total Drug Medicare AllowedAmount | 280.44 |
| Total Drug Medicare PaymentAmount | 206.28 |
| Total Drug Medicare Standardized Payment Amount | 206.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 138 |
| Number Of Medical Services | 4246 |
| Number Of Medicare Beneficiaries With Medical Services | 2409 |
| Total Medical Submitted Charge Amount | 377505 |
| Total Medical Medicare Allowed Amount | 118257.35 |
| Total Medical Medicare Payment Amount | 88013.65 |
| Total Medical Medicare Standardized Payment Amount | 90525.71 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 553 |
| Number Of Beneficiaries Age 65 to 74 | 923 |
| Number Of Beneficiaries Age 75 to 84 | 599 |
| Number Of Beneficiaries Age Greater 84 | 334 |
| Number Of Female Beneficiaries | 1394 |
| Number Of Male Beneficiaries | 1015 |
| Number Of Non Hispanic White Beneficiaries | 1482 |
| Number Of Black or African American Beneficiaries | 512 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 366 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1782 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 627 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8227 |