| National Provider Identifier [NPI]: | 1205879988 |
| Last Name Of The Provider | BOGNANNO |
| First Name Of The Provider | JAMES |
| 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 | 7340 SHADELAND STA STE 200 |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462563980 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 5989 |
| Number Of Medicare Beneficiaries | 4193 |
| Total Submitted Charge Amount | 594660 |
| Total Medicare Allowed Amount | 215622.63 |
| Total Medicare Payment Amount | 161165.22 |
| Total Medicare Standardized Payment Amount | 172374.47 |
| 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 | 199 |
| Number Of Medical Services | 5989 |
| Number Of Medicare Beneficiaries With Medical Services | 4193 |
| Total Medical Submitted Charge Amount | 594660 |
| Total Medical Medicare Allowed Amount | 215622.63 |
| Total Medical Medicare Payment Amount | 161165.22 |
| Total Medical Medicare Standardized Payment Amount | 172374.47 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 947 |
| Number Of Beneficiaries Age 65 to 74 | 1419 |
| Number Of Beneficiaries Age 75 to 84 | 1165 |
| Number Of Beneficiaries Age Greater 84 | 662 |
| Number Of Female Beneficiaries | 2581 |
| Number Of Male Beneficiaries | 1612 |
| Number Of Non Hispanic White Beneficiaries | 3334 |
| Number Of Black or African American Beneficiaries | 744 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2989 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1204 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6755 |