| National Provider Identifier [NPI]: | 1992897680 |
| Last Name Of The Provider | CHANAMOLU |
| First Name Of The Provider | SREENIVASA |
| 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 | 770 W HIGH ST |
| Street Address 2 Of The Provider | SUITE 240 |
| City Of The Provider | LIMA |
| Zip Code Of The Provider | 458013990 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 4084 |
| Number Of Medicare Beneficiaries | 1189 |
| Total Submitted Charge Amount | 567948 |
| Total Medicare Allowed Amount | 369431.17 |
| Total Medicare Payment Amount | 283293.03 |
| Total Medicare Standardized Payment Amount | 290987.91 |
| 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 | 50 |
| Number Of Medical Services | 4084 |
| Number Of Medicare Beneficiaries With Medical Services | 1189 |
| Total Medical Submitted Charge Amount | 567948 |
| Total Medical Medicare Allowed Amount | 369431.17 |
| Total Medical Medicare Payment Amount | 283293.03 |
| Total Medical Medicare Standardized Payment Amount | 290987.91 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 258 |
| Number Of Beneficiaries Age 65 to 74 | 486 |
| Number Of Beneficiaries Age 75 to 84 | 326 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 579 |
| Number Of Male Beneficiaries | 610 |
| Number Of Non Hispanic White Beneficiaries | 1081 |
| Number Of Black or African American Beneficiaries | 77 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 925 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 264 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 52 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7456 |