| National Provider Identifier [NPI]: | 1740279082 |
| Last Name Of The Provider | KANDALLU |
| First Name Of The Provider | KANNAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5454 HOHMAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HAMMOND |
| Zip Code Of The Provider | 463201931 |
| 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 | 155 |
| Number Of Services | 3195 |
| Number Of Medicare Beneficiaries | 1901 |
| Total Submitted Charge Amount | 336213 |
| Total Medicare Allowed Amount | 81392.06 |
| Total Medicare Payment Amount | 56736.58 |
| Total Medicare Standardized Payment Amount | 59888.89 |
| 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 | 155 |
| Number Of Medical Services | 3195 |
| Number Of Medicare Beneficiaries With Medical Services | 1901 |
| Total Medical Submitted Charge Amount | 336213 |
| Total Medical Medicare Allowed Amount | 81392.06 |
| Total Medical Medicare Payment Amount | 56736.58 |
| Total Medical Medicare Standardized Payment Amount | 59888.89 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 374 |
| Number Of Beneficiaries Age 65 to 74 | 584 |
| Number Of Beneficiaries Age 75 to 84 | 572 |
| Number Of Beneficiaries Age Greater 84 | 371 |
| Number Of Female Beneficiaries | 1060 |
| Number Of Male Beneficiaries | 841 |
| Number Of Non Hispanic White Beneficiaries | 1321 |
| Number Of Black or African American Beneficiaries | 432 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 123 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1255 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 646 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 45 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.5489 |