National Provider Identifier [NPI]: |
1861420861 |
Last Name Of The Provider |
SUFI |
First Name Of The Provider |
AJAY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
18111 PRINCE PHILIP DR |
Street Address 2 Of The Provider |
T-20 |
City Of The Provider |
OLNEY |
Zip Code Of The Provider |
208321513 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
136 |
Number Of Services |
14893 |
Number Of Medicare Beneficiaries |
3105 |
Total Submitted Charge Amount |
1380595.93 |
Total Medicare Allowed Amount |
561178.56 |
Total Medicare Payment Amount |
469458.4 |
Total Medicare Standardized Payment Amount |
418092.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
9848 |
Number Of Medicare Beneficiaries With Drug Services |
99 |
Total Drug Submitted ChargeAmount |
2668.04 |
Total Drug Medicare AllowedAmount |
2063.04 |
Total Drug Medicare PaymentAmount |
1534.15 |
Total Drug Medicare Standardized Payment Amount |
1534.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
132 |
Number Of Medical Services |
5045 |
Number Of Medicare Beneficiaries With Medical Services |
3105 |
Total Medical Submitted Charge Amount |
1377927.89 |
Total Medical Medicare Allowed Amount |
559115.52 |
Total Medical Medicare Payment Amount |
467924.25 |
Total Medical Medicare Standardized Payment Amount |
416558.09 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
411 |
Number Of Beneficiaries Age 65 to 74 |
1569 |
Number Of Beneficiaries Age 75 to 84 |
834 |
Number Of Beneficiaries Age Greater 84 |
291 |
Number Of Female Beneficiaries |
2504 |
Number Of Male Beneficiaries |
601 |
Number Of Non Hispanic White Beneficiaries |
1864 |
Number Of Black or African American Beneficiaries |
779 |
Number Of AsianPacific Islander Beneficiaries |
182 |
Number Of Hispanic Beneficiaries |
194 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
2538 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
567 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0408 |