| National Provider Identifier [NPI]: | 1891772877 |
| Last Name Of The Provider | SUNTHARAM |
| First Name Of The Provider | NILA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3850 PARK NICOLLET BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST LOUIS PARK |
| Zip Code Of The Provider | 554162527 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 2406 |
| Number Of Medicare Beneficiaries | 954 |
| Total Submitted Charge Amount | 136248.75 |
| Total Medicare Allowed Amount | 76768.64 |
| Total Medicare Payment Amount | 66604.67 |
| Total Medicare Standardized Payment Amount | 68050.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 898 |
| Number Of Medicare Beneficiaries With Drug Services | 855 |
| Total Drug Submitted ChargeAmount | 16517 |
| Total Drug Medicare AllowedAmount | 14575.48 |
| Total Drug Medicare PaymentAmount | 14251.95 |
| Total Drug Medicare Standardized Payment Amount | 14251.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 1508 |
| Number Of Medicare Beneficiaries With Medical Services | 936 |
| Total Medical Submitted Charge Amount | 119731.75 |
| Total Medical Medicare Allowed Amount | 62193.16 |
| Total Medical Medicare Payment Amount | 52352.72 |
| Total Medical Medicare Standardized Payment Amount | 53798.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 128 |
| Number Of Beneficiaries Age 65 to 74 | 386 |
| Number Of Beneficiaries Age 75 to 84 | 302 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 523 |
| Number Of Male Beneficiaries | 431 |
| Number Of Non Hispanic White Beneficiaries | 872 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 828 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 126 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 35 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1145 |