| National Provider Identifier [NPI]: | 1811040595 |
| Last Name Of The Provider | SUNDARAM |
| First Name Of The Provider | RAVI |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4001 VOLLMER RD. |
| Street Address 2 Of The Provider | |
| City Of The Provider | OLYMPIA FIELDS |
| Zip Code Of The Provider | 604611073 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 3463 |
| Number Of Medicare Beneficiaries | 786 |
| Total Submitted Charge Amount | 819826 |
| Total Medicare Allowed Amount | 430759.41 |
| Total Medicare Payment Amount | 336040.52 |
| Total Medicare Standardized Payment Amount | 313578.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1420 |
| Total Drug Medicare AllowedAmount | 1022.75 |
| Total Drug Medicare PaymentAmount | 1002.26 |
| Total Drug Medicare Standardized Payment Amount | 1002.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 3441 |
| Number Of Medicare Beneficiaries With Medical Services | 786 |
| Total Medical Submitted Charge Amount | 818406 |
| Total Medical Medicare Allowed Amount | 429736.66 |
| Total Medical Medicare Payment Amount | 335038.26 |
| Total Medical Medicare Standardized Payment Amount | 312576.02 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 168 |
| Number Of Beneficiaries Age 65 to 74 | 219 |
| Number Of Beneficiaries Age 75 to 84 | 247 |
| Number Of Beneficiaries Age Greater 84 | 152 |
| Number Of Female Beneficiaries | 436 |
| Number Of Male Beneficiaries | 350 |
| Number Of Non Hispanic White Beneficiaries | 409 |
| Number Of Black or African American Beneficiaries | 326 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 434 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 352 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 29 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 58 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 57 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.8425 |