| National Provider Identifier [NPI]: | 1922216803 |
| Last Name Of The Provider | MUKHERJEE |
| First Name Of The Provider | SUGOTO |
| 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 | LEE ST FL 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229080001 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 129 |
| Number Of Services | 8985 |
| Number Of Medicare Beneficiaries | 1827 |
| Total Submitted Charge Amount | 3001277.48 |
| Total Medicare Allowed Amount | 309174.03 |
| Total Medicare Payment Amount | 233157.16 |
| Total Medicare Standardized Payment Amount | 245116.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 5425 |
| Number Of Medicare Beneficiaries With Drug Services | 356 |
| Total Drug Submitted ChargeAmount | 32166.48 |
| Total Drug Medicare AllowedAmount | 2759.89 |
| Total Drug Medicare PaymentAmount | 2136.28 |
| Total Drug Medicare Standardized Payment Amount | 2136.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 123 |
| Number Of Medical Services | 3560 |
| Number Of Medicare Beneficiaries With Medical Services | 1827 |
| Total Medical Submitted Charge Amount | 2969111 |
| Total Medical Medicare Allowed Amount | 306414.14 |
| Total Medical Medicare Payment Amount | 231020.88 |
| Total Medical Medicare Standardized Payment Amount | 242980.07 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 413 |
| Number Of Beneficiaries Age 65 to 74 | 745 |
| Number Of Beneficiaries Age 75 to 84 | 493 |
| Number Of Beneficiaries Age Greater 84 | 176 |
| Number Of Female Beneficiaries | 956 |
| Number Of Male Beneficiaries | 871 |
| Number Of Non Hispanic White Beneficiaries | 1544 |
| Number Of Black or African American Beneficiaries | 223 |
| 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 | 37 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1423 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 404 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.5568 |