| National Provider Identifier [NPI]: | 1457386922 |
| Last Name Of The Provider | BRAHMAMDAM |
| First Name Of The Provider | JAGANNADHARAO |
| 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 | 812 N LOGAN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DANVILLE |
| Zip Code Of The Provider | 618323752 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 217 |
| Number Of Services | 19496 |
| Number Of Medicare Beneficiaries | 3431 |
| Total Submitted Charge Amount | 1416264 |
| Total Medicare Allowed Amount | 343104.4 |
| Total Medicare Payment Amount | 268846.83 |
| Total Medicare Standardized Payment Amount | 281640.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 11310 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 22620 |
| Total Drug Medicare AllowedAmount | 2112.7 |
| Total Drug Medicare PaymentAmount | 1645.57 |
| Total Drug Medicare Standardized Payment Amount | 1645.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 216 |
| Number Of Medical Services | 8186 |
| Number Of Medicare Beneficiaries With Medical Services | 3431 |
| Total Medical Submitted Charge Amount | 1393644 |
| Total Medical Medicare Allowed Amount | 340991.7 |
| Total Medical Medicare Payment Amount | 267201.26 |
| Total Medical Medicare Standardized Payment Amount | 279994.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 782 |
| Number Of Beneficiaries Age 65 to 74 | 1177 |
| Number Of Beneficiaries Age 75 to 84 | 898 |
| Number Of Beneficiaries Age Greater 84 | 574 |
| Number Of Female Beneficiaries | 2208 |
| Number Of Male Beneficiaries | 1223 |
| Number Of Non Hispanic White Beneficiaries | 2969 |
| Number Of Black or African American Beneficiaries | 378 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2367 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1064 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.473 |