| National Provider Identifier [NPI]: | 1548313588 |
| Last Name Of The Provider | JAISWAL |
| First Name Of The Provider | SUNNY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 281 LINCOLN ST |
| Street Address 2 Of The Provider | MED STAFF SVCS |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 016052138 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 2200 |
| Number Of Medicare Beneficiaries | 1661 |
| Total Submitted Charge Amount | 404877 |
| Total Medicare Allowed Amount | 114578.79 |
| Total Medicare Payment Amount | 86727.02 |
| Total Medicare Standardized Payment Amount | 89448.6 |
| 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 | 69 |
| Number Of Medical Services | 2200 |
| Number Of Medicare Beneficiaries With Medical Services | 1661 |
| Total Medical Submitted Charge Amount | 404877 |
| Total Medical Medicare Allowed Amount | 114578.79 |
| Total Medical Medicare Payment Amount | 86727.02 |
| Total Medical Medicare Standardized Payment Amount | 89448.6 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 597 |
| Number Of Beneficiaries Age 65 to 74 | 633 |
| Number Of Beneficiaries Age 75 to 84 | 342 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 743 |
| Number Of Male Beneficiaries | 918 |
| Number Of Non Hispanic White Beneficiaries | 1313 |
| Number Of Black or African American Beneficiaries | 278 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1080 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 581 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.4501 |