Dr. Sameh F Gadallah , MD
Specialist • Lancaster, CA
43723 20th St W
Lancaster, CA 935344784
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on March 28, 2006; this date does not establish years in practice.
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Published CMS data list 2,294 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99215 — Established patient outpatient office visit: 660 service units.
- 93010 — Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only: 253 service units.
- 93306 — Ultrasound of heart with color-depicted blood flow, rate, direction and valve function: 206 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See all 25 records in the table · Guide: How to read Medicare Part B data
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Published CMS data list 3,706 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Rosuvastatin Calcium — 354 prescription fills, including refills.
- Amlodipine Besylate — 301 prescription fills, including refills.
- Atorvastatin Calcium — 276 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See all 54 records in the table · Guide: How to read Medicare Part D prescriber data
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Close to the middle for Medicare Part B services among clinicians listed under Specialist in Lancaster, CA (2024, 12 clinicians with data). Median for this group: 2,430. Middle half: 1,290 to 3,832.
More Medicare Part B services than 60% of clinicians listed under Specialist in California (2024, 971 clinicians with data). Median for this group: 1,449. Middle half: 398 to 4,263.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 2,229 in 2020 to 2,294 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020–2024.
Practice Location & Contact Primary Location
43723 20th St W
Lancaster, CA 935344784
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
CMS Doctors and Clinicians lists 1 group name: Antelope Valley Cardiology Associates. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
1981
What Public CMS Data Show
Specialist: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
944 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.
Medicare-allowed amount
About $317,774 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
Paid by Medicare
About $236,501 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
30-day fills
9,504 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$609,562 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.
Open Payments general payments, program year 2025
All general payments: $7,074.12 across 86 records.
By nature of payment
- Travel and Lodging: $4,465.33 across 15 records.
- Food and Beverage: $2,583.09 across 70 records.
- Education: $25.70 across 1 record.
Reporting-company totals (3 largest of 16)
- Edwards Lifesciences Corporation: $3,356.55 across 18 records.
- Abbott Laboratories: $1,802.38 across 18 records.
- Medtronic, Inc.: $1,048.60 across 11 records.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).
Years since graduation
45 years (graduated 1981)
CMS Doctors and Clinicians data list 1981 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2006
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Dr. Gadallah has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Dr. Gadallah as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Lancaster and California
Billing and prescribing volume is not a quality rating.
Medicare Part B services
Close to the middle for clinicians listed under Specialist in Lancaster, CA (2024, 12 clinicians with data). Median for this group: 2,430. Middle half: 1,290 to 3,832.
More Medicare Part B services than 60% of clinicians listed under Specialist in California (2024, 971 clinicians with data). Median for this group: 1,449. Middle half: 398 to 4,263.
Medicare-allowed amount
A higher Medicare-allowed amount than 60% of clinicians listed under Specialist in Lancaster, CA (2024, 12 clinicians with data). Median for this group: $252,415. Middle half: $124,697 to $382,459.
A higher Medicare-allowed amount than 75% of clinicians listed under Specialist in California (2024, 971 clinicians with data). Median for this group: $122,660. Middle half: $39,588 to $306,948.
Paid by Medicare
Close to the middle for clinicians listed under Specialist in Lancaster, CA (2024, 12 clinicians with data). Median for this group: $188,258. Middle half: $90,240 to $282,947.
A higher Medicare payment amount than 75% of clinicians listed under Specialist in California (2024, 971 clinicians with data). Median for this group: $93,548. Middle half: $29,320 to $233,743.
Medicare Part D prescriptions
More Part D prescriptions than 65% of clinicians listed under Specialist in Lancaster, CA (2024, 16 clinicians with data). Median for this group: 2,542. Middle half: 1,008 to 4,054.
More Part D prescriptions than 85% of clinicians listed under Specialist in California (2024, 1,051 clinicians with data). Median for this group: 499. Middle half: 100 to 1,747.
Part D drug cost
A higher Part D drug cost than 65% of clinicians listed under Specialist in Lancaster, CA (2024, 16 clinicians with data). Median for this group: $254,316. Middle half: $77,896 to $945,260.
A higher Part D drug cost than 80% of clinicians listed under Specialist in California (2024, 1,051 clinicians with data). Median for this group: $36,951. Middle half: $2,246 to $302,101.
28 active clinicians are listed under Specialist with a practice address in Lancaster, CA (5,761 in California).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Lancaster
17.9% of these 28 clinicians have the CMS telehealth indicator.
53.6% of these 28 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services stayed about the same: 2,229 in 2020 and 2,294 in 2024.
- 2020: 2,229
- 2021: 2,068
- 2022: 2,200
- 2023: 2,052
- 2024: 2,294
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Medicare-allowed amount
Medicare-allowed amount increased 18% from $269,845 in 2020 to $317,774 in 2024.
- 2020: $269,845
- 2021: $224,495
- 2022: $281,747
- 2023: $275,602
- 2024: $317,774
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Paid by Medicare
Paid by Medicare increased 20% from $197,734 in 2020 to $236,501 in 2024.
- 2020: $197,734
- 2021: $161,922
- 2022: $204,899
- 2023: $200,439
- 2024: $236,501
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Medicare Part D prescriptions
Medicare Part D prescriptions stayed about the same: 3,502 in 2020 and 3,706 in 2024.
- 2020: 3,502
- 2021: 3,386
- 2022: 3,524
- 2023: 3,567
- 2024: 3,706
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30-day fills
30-day fills stayed about the same: 8,852 in 2020 and 9,504 in 2024.
- 2020: 8,852
- 2021: 8,726
- 2022: 9,327
- 2023: 9,224
- 2024: 9,504
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Part D drug cost
Part D drug cost increased 52% from $401,210 in 2020 to $609,562 in 2024.
- 2020: $401,210
- 2021: $390,285
- 2022: $452,443
- 2023: $542,311
- 2024: $609,562
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $994.38 in 2021 to $7,074.12 in 2025.
- 2021: $994.38
- 2022: $916.52
- 2023: $1,037.33
- 2024: $2,145.69
- 2025: $7,074.12
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 – December 31, 2025): 86 records totaling $7,074.12.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Edwards Lifesciences Corporation |
Travel and Lodging
In-kind items and services
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— | General | $1,337.41 |
| Medtronic, Inc. |
Travel and Lodging
In-kind items and services
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EVERA MRI XT DR SURESCAN | General | $509.21 |
| Abbott Laboratories |
Travel and Lodging
In-kind items and services
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TRICLIP | General | $508.95 |
| Edwards Lifesciences Corporation |
Travel and Lodging
In-kind items and services
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SAPIEN 3 Ultra RESILIA | General | $406.70 |
| Edwards Lifesciences Corporation |
Travel and Lodging
In-kind items and services
|
SAPIEN 3 Ultra RESILIA | General | $406.70 |
| Abbott Laboratories |
Travel and Lodging
In-kind items and services
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TRICLIP | General | $339.90 |
| Abbott Laboratories |
Travel and Lodging
In-kind items and services
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TRICLIP | General | $286.72 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
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SAPIEN 3 Ultra RESILIA | General | $243.60 |
| Medtronic, Inc. |
Travel and Lodging
In-kind items and services
|
— | General | $189.00 |
| Abbott Laboratories |
Travel and Lodging
In-kind items and services
|
TRICLIP | General | $180.22 |
| Abbott Laboratories |
Food and Beverage
In-kind items and services
|
TRICLIP | General | $162.45 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
|
EVOQUE | General | $152.67 |
| Edwards Lifesciences Corporation |
Travel and Lodging
In-kind items and services
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SAPIEN 3 Ultra RESILIA | General | $145.62 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
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SAPIEN 3 Ultra RESILIA | General | $102.30 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
|
SAPIEN 3 Ultra RESILIA | General | $97.42 |
| Medtronic, Inc. |
Food and Beverage
In-kind items and services
|
EVERA MRI XT DR SURESCAN | General | $96.51 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
|
SAPIEN 3 Ultra RESILIA | General | $88.85 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
|
SAPIEN 3 Ultra RESILIA | General | $87.29 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
|
SAPIEN 3 Ultra RESILIA | General | $81.84 |
| Medtronic, Inc. |
Food and Beverage
In-kind items and services
|
EVERA MRI XT DR SURESCAN | General | $77.90 |
| Edwards Lifesciences Corporation |
Food and Beverage
In-kind items and services
|
SAPIEN 3 Ultra RESILIA | General | $58.49 |
| Medtronic, Inc. |
Food and Beverage
In-kind items and services
|
EVERA MRI XT DR SURESCAN | General | $47.35 |
| Edwards Lifesciences Corporation |
Travel and Lodging
In-kind items and services
|
SAPIEN 3 Ultra RESILIA | General | $46.76 |
| Medtronic, Inc. |
Food and Beverage
In-kind items and services
|
— | General | $39.68 |
| Abbott Laboratories |
Travel and Lodging
In-kind items and services
|
TRICLIP | General | $38.83 |
(top 25 shown)
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99215
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
|
660 | 411 | $321.00 | $203.42 |
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93010
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
|
253 | 199 | $18.00 | $8.83 |
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93306
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
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206 | 194 | $520.00 | $230.02 |
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93306
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
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194 | 190 | $140.00 | $74.82 |
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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
|
142 | 133 | $239.00 | $142.97 |
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99233
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes
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125 | 52 | $226.00 | $129.59 |
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93297
Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days
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99 | 26 | $60.00 | $62.28 |
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99205
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more
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80 | 80 | $455.00 | $244.78 |
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99223
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
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67 | 66 | $441.00 | $189.24 |
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93295
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days
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52 | 23 | $150.00 | $39.67 |
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93294
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days
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48 | 30 | $80.00 | $31.94 |
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93298
Evaluation of cardiac rhythm monitor system, remote up to 30 days
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47 | 12 | $60.00 | $62.24 |
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93246
Heart rhythm recording of continous external ekg over 8-15 days
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42 | 40 | $31.00 | $14.60 |
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93248
Heart rhythm review and interpretation of continous external ekg over 8-15 days
|
42 | 40 | $55.00 | $27.59 |
|
93308
Ultrasound of heart, follow-up
|
32 | 30 | $225.00 | $27.02 |
|
93312
Ultrasound of heart with probe in esophagus, with report
|
27 | 25 | $696.00 | $115.16 |
|
93458
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist
|
27 | 25 | $683.00 | $210.31 |
|
93320
Ultrasound of heart blood flow, valves and chambers
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26 | 24 | $125.00 | $19.34 |
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93325
Ultrasound of heart with color-depicted blood flow, rate and valve function
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26 | 24 | $100.00 | $3.35 |
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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22 | 22 | $161.00 | $103.07 |
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93280
Programming of dual lead pacemaker system
|
18 | 17 | $130.00 | $91.32 |
|
33340
Repair of left upper heart chamber with implant with review by radiologist
|
16 | 15 | $1609.00 | $784.93 |
|
93296
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days
|
16 | 15 | $62.00 | $26.22 |
|
92928
Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch
|
14 | 13 | $1327.00 | $585.54 |
|
99490
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month
|
13 | 13 | $61.56 | $64.08 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Rosuvastatin Calcium | Rosuvastatin Calcium | 354 | 30,564 | $6,215.45 | 107 |
| Amlodipine Besylate | Amlodipine Besylate | 301 | 24,842 | $2,059.16 | 94 |
| Atorvastatin Calcium | Atorvastatin Calcium | 276 | 23,035 | $2,598.03 | 89 |
| Metoprolol Succinate | Metoprolol Succinate | 253 | 22,590 | $4,138.62 | 81 |
| Clopidogrel | Clopidogrel Bisulfate | 247 | 20,793 | $2,893.58 | 81 |
| Lisinopril | Lisinopril | 168 | 13,532 | $891.08 | 46 |
| Losartan Potassium | Losartan Potassium | 161 | 14,130 | $1,206.23 | 53 |
| Metoprolol Tartrate | Metoprolol Tartrate | 148 | 11,317 | $840.98 | 44 |
| Eliquis | Apixaban | 148 | 10,575 | $205,292.67 | 45 |
| Furosemide | Furosemide | 128 | 9,606 | $714.34 | 37 |
| Valsartan | Valsartan | 118 | 9,673 | $2,991.25 | 34 |
| Carvedilol | Carvedilol | 113 | 9,110 | $1,058.62 | 34 |
| Metformin Hcl | Metformin Hcl | 85 | 6,455 | $463.37 | 28 |
| Spironolactone | Spironolactone | 78 | 5,640 | $715.31 | 25 |
| Amiodarone Hcl | Amiodarone Hcl | 75 | 5,805 | $5,861.24 | 23 |
| Levothyroxine Sodium | Levothyroxine Sodium | 67 | 5,836 | $611.05 | 20 |
| Hydrochlorothiazide | Hydrochlorothiazide | 64 | 5,130 | $324.25 | 22 |
| Entresto | Sacubitril/Valsartan | 62 | 3,270 | $71,168.17 | 16 |
| Ozempic | Semaglutide | 61 | 2,584 | $63,214.26 | 14 |
| Jardiance | Empagliflozin | 47 | 3,690 | $68,905.61 | 17 |
| Zolpidem Tartrate | Zolpidem Tartrate | 45 | 1,350 | $279.37 | 11 |
| Farxiga | Dapagliflozin Propanediol | 45 | 3,150 | $56,787.56 | 15 |
| Nitroglycerin | Nitroglycerin | 40 | 1,363 | $756.88 | 18 |
| Xarelto | Rivaroxaban | 37 | 2,730 | $49,212.52 | 12 |
| Atenolol | Atenolol | 31 | 2,790 | $386.00 | — |
(top 25 shown)
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2020-03-13NUCC Taxonomy Code: 174400000X
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Additional State Medicaid & Healthcare Payer Identifiers
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - CARDIOVASCULAR DISEASE (CARDIOLOGY)
I20070524000249
CA
7911907910
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
Antelope Valley Cardiology Associates
43723 20th St W, Lancaster, CA 935344784
Phone: 6616744222
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Specialist
Doctor of Medicine (M.D.)
Career & Practice History
NPI enumerated March 28, 2006.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to November 2026.
NPI Administrative Meta
Other Specialists in Lancaster
- Dr. James Ngo, MD
- Dr. Syed Hasan, MD
- Dr. Pradeep Damle, MD
- Dr. Marites Del Rosario, MD
- Dr. Shun Sunder, MD
- Dr. Reuven Minkowitz, MD
Mailing Address
Po Box 2030
Lancaster, CA 935392030
Phone: 6616744222