| National Provider Identifier [NPI]: | 1275599458 |
| Last Name Of The Provider | MUTTATH |
| First Name Of The Provider | SURESHKUMAR |
| 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 | 5711 SARVIS AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | RIVERDALE |
| Zip Code Of The Provider | 207371394 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 22091 |
| Number Of Medicare Beneficiaries | 511 |
| Total Submitted Charge Amount | 1883710 |
| Total Medicare Allowed Amount | 923057.28 |
| Total Medicare Payment Amount | 706761.39 |
| Total Medicare Standardized Payment Amount | 631326.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 9106 |
| Number Of Medicare Beneficiaries With Drug Services | 348 |
| Total Drug Submitted ChargeAmount | 236652 |
| Total Drug Medicare AllowedAmount | 119100.06 |
| Total Drug Medicare PaymentAmount | 95868.34 |
| Total Drug Medicare Standardized Payment Amount | 95868.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 62 |
| Number Of Medical Services | 12985 |
| Number Of Medicare Beneficiaries With Medical Services | 511 |
| Total Medical Submitted Charge Amount | 1647058 |
| Total Medical Medicare Allowed Amount | 803957.22 |
| Total Medical Medicare Payment Amount | 610893.05 |
| Total Medical Medicare Standardized Payment Amount | 535458.61 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 221 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 303 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 235 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| 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 | 396 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 115 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 55 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5393 |