| National Provider Identifier [NPI]: | 1003804204 |
| Last Name Of The Provider | EAPEN |
| First Name Of The Provider | SAJI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 930 E EMERALD AVE |
| Street Address 2 Of The Provider | SUITE 611 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379174539 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 2498 |
| Number Of Medicare Beneficiaries | 320 |
| Total Submitted Charge Amount | 374378.16 |
| Total Medicare Allowed Amount | 155144.58 |
| Total Medicare Payment Amount | 111118.71 |
| Total Medicare Standardized Payment Amount | 128670.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 329 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 25098 |
| Total Drug Medicare AllowedAmount | 12978.61 |
| Total Drug Medicare PaymentAmount | 10155.06 |
| Total Drug Medicare Standardized Payment Amount | 10155.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 2169 |
| Number Of Medicare Beneficiaries With Medical Services | 320 |
| Total Medical Submitted Charge Amount | 349280.16 |
| Total Medical Medicare Allowed Amount | 142165.97 |
| Total Medical Medicare Payment Amount | 100963.65 |
| Total Medical Medicare Standardized Payment Amount | 118515.77 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 110 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 165 |
| Number Of Male Beneficiaries | 155 |
| Number Of Non Hispanic White Beneficiaries | 287 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 207 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 113 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.2114 |