| National Provider Identifier [NPI]: | 1255523551 |
| Last Name Of The Provider | JOLLU |
| First Name Of The Provider | CHAYAPATHY |
| 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 | 1601 ROOSEVELT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NIAGARA |
| Zip Code Of The Provider | 541511043 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 9651 |
| Number Of Medicare Beneficiaries | 1174 |
| Total Submitted Charge Amount | 1491003 |
| Total Medicare Allowed Amount | 792042.78 |
| Total Medicare Payment Amount | 616463.62 |
| Total Medicare Standardized Payment Amount | 618228.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 299 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 983 |
| Total Drug Medicare AllowedAmount | 417.44 |
| Total Drug Medicare PaymentAmount | 323.76 |
| Total Drug Medicare Standardized Payment Amount | 323.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 9352 |
| Number Of Medicare Beneficiaries With Medical Services | 1174 |
| Total Medical Submitted Charge Amount | 1490020 |
| Total Medical Medicare Allowed Amount | 791625.34 |
| Total Medical Medicare Payment Amount | 616139.86 |
| Total Medical Medicare Standardized Payment Amount | 617905.05 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 266 |
| Number Of Beneficiaries Age 75 to 84 | 416 |
| Number Of Beneficiaries Age Greater 84 | 369 |
| Number Of Female Beneficiaries | 716 |
| Number Of Male Beneficiaries | 458 |
| Number Of Non Hispanic White Beneficiaries | 1018 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 808 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 366 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 52 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 53 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.3274 |