| National Provider Identifier [NPI]: | 1043228083 |
| Last Name Of The Provider | VADMAL |
| First Name Of The Provider | MANJUNATH |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 191 S BUENA VISTA ST |
| Street Address 2 Of The Provider | SUITE 475 |
| City Of The Provider | BURBANK |
| Zip Code Of The Provider | 915054554 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 14107 |
| Number Of Medicare Beneficiaries | 3113 |
| Total Submitted Charge Amount | 2221023 |
| Total Medicare Allowed Amount | 864455.89 |
| Total Medicare Payment Amount | 644375.09 |
| Total Medicare Standardized Payment Amount | 525602.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 505 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 23035 |
| Total Drug Medicare AllowedAmount | 16289.4 |
| Total Drug Medicare PaymentAmount | 12574.5 |
| Total Drug Medicare Standardized Payment Amount | 12574.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 13602 |
| Number Of Medicare Beneficiaries With Medical Services | 3113 |
| Total Medical Submitted Charge Amount | 2197988 |
| Total Medical Medicare Allowed Amount | 848166.49 |
| Total Medical Medicare Payment Amount | 631800.59 |
| Total Medical Medicare Standardized Payment Amount | 513027.54 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 161 |
| Number Of Beneficiaries Age 65 to 74 | 1543 |
| Number Of Beneficiaries Age 75 to 84 | 984 |
| Number Of Beneficiaries Age Greater 84 | 425 |
| Number Of Female Beneficiaries | 1274 |
| Number Of Male Beneficiaries | 1839 |
| Number Of Non Hispanic White Beneficiaries | 2850 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 136 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 63 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2920 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 193 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0272 |