| National Provider Identifier [NPI]: | 1003846635 |
| Last Name Of The Provider | PRAKASH |
| First Name Of The Provider | JAY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6555 PROFESSIONAL PL |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | RIVERDALE |
| Zip Code Of The Provider | 302742519 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 940 |
| Number Of Medicare Beneficiaries | 447 |
| Total Submitted Charge Amount | 203055 |
| Total Medicare Allowed Amount | 92962.21 |
| Total Medicare Payment Amount | 68096.3 |
| Total Medicare Standardized Payment Amount | 69485.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 940 |
| Number Of Medicare Beneficiaries With Medical Services | 447 |
| Total Medical Submitted Charge Amount | 203055 |
| Total Medical Medicare Allowed Amount | 92962.21 |
| Total Medical Medicare Payment Amount | 68096.3 |
| Total Medical Medicare Standardized Payment Amount | 69485.74 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 244 |
| Number Of Beneficiaries Age 75 to 84 | 102 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 174 |
| Number Of Non Hispanic White Beneficiaries | 308 |
| Number Of Black or African American Beneficiaries | 106 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 385 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 62 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1253 |