| National Provider Identifier [NPI]: | 1538143714 |
| Last Name Of The Provider | MANDAVA |
| First Name Of The Provider | ANEEL |
| 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 | 2801 K ST |
| Street Address 2 Of The Provider | SUITE 502 |
| City Of The Provider | SACRAMENTO |
| Zip Code Of The Provider | 958165120 |
| 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 | 158 |
| Number Of Services | 1662 |
| Number Of Medicare Beneficiaries | 425 |
| Total Submitted Charge Amount | 1468010.8 |
| Total Medicare Allowed Amount | 134271.52 |
| Total Medicare Payment Amount | 104252.28 |
| Total Medicare Standardized Payment Amount | 101911.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 576 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 576 |
| Total Drug Medicare AllowedAmount | 136.44 |
| Total Drug Medicare PaymentAmount | 106.96 |
| Total Drug Medicare Standardized Payment Amount | 106.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 156 |
| Number Of Medical Services | 1086 |
| Number Of Medicare Beneficiaries With Medical Services | 425 |
| Total Medical Submitted Charge Amount | 1467434.8 |
| Total Medical Medicare Allowed Amount | 134135.08 |
| Total Medical Medicare Payment Amount | 104145.32 |
| Total Medical Medicare Standardized Payment Amount | 101804.06 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 129 |
| Number Of Beneficiaries Age Greater 84 | 69 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 225 |
| Number Of Non Hispanic White Beneficiaries | 343 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 63 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.9229 |