| National Provider Identifier [NPI]: | 1851453211 |
| Last Name Of The Provider | DODDAPANENI |
| First Name Of The Provider | AJAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7920 MERRILL RD UNIT 708 |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 32277 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 271 |
| Number Of Services | 10500 |
| Number Of Medicare Beneficiaries | 3876 |
| Total Submitted Charge Amount | 1473199.9 |
| Total Medicare Allowed Amount | 251246.65 |
| Total Medicare Payment Amount | 188206.17 |
| Total Medicare Standardized Payment Amount | 187251.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2855 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 2069.4 |
| Total Drug Medicare AllowedAmount | 583.65 |
| Total Drug Medicare PaymentAmount | 443.53 |
| Total Drug Medicare Standardized Payment Amount | 443.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 269 |
| Number Of Medical Services | 7645 |
| Number Of Medicare Beneficiaries With Medical Services | 3876 |
| Total Medical Submitted Charge Amount | 1471130.5 |
| Total Medical Medicare Allowed Amount | 250663 |
| Total Medical Medicare Payment Amount | 187762.64 |
| Total Medical Medicare Standardized Payment Amount | 186808.02 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 799 |
| Number Of Beneficiaries Age 65 to 74 | 1200 |
| Number Of Beneficiaries Age 75 to 84 | 1139 |
| Number Of Beneficiaries Age Greater 84 | 738 |
| Number Of Female Beneficiaries | 2171 |
| Number Of Male Beneficiaries | 1705 |
| Number Of Non Hispanic White Beneficiaries | 2560 |
| Number Of Black or African American Beneficiaries | 488 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 739 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 47 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2613 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1263 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.1153 |