| National Provider Identifier [NPI]: | 1104033950 |
| Last Name Of The Provider | VAIDYANATHAN |
| First Name Of The Provider | SURYA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 MEADOWS RD |
| Street Address 2 Of The Provider | SUITE 1C |
| City Of The Provider | BOCA RATON |
| Zip Code Of The Provider | 334862304 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 8014 |
| Number Of Medicare Beneficiaries | 3047 |
| Total Submitted Charge Amount | 608883.3 |
| Total Medicare Allowed Amount | 285727 |
| Total Medicare Payment Amount | 245494.75 |
| Total Medicare Standardized Payment Amount | 234749.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2065 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1873.3 |
| Total Drug Medicare AllowedAmount | 878.59 |
| Total Drug Medicare PaymentAmount | 679.93 |
| Total Drug Medicare Standardized Payment Amount | 679.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 5949 |
| Number Of Medicare Beneficiaries With Medical Services | 3047 |
| Total Medical Submitted Charge Amount | 607010 |
| Total Medical Medicare Allowed Amount | 284848.41 |
| Total Medical Medicare Payment Amount | 244814.82 |
| Total Medical Medicare Standardized Payment Amount | 234069.36 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 1412 |
| Number Of Beneficiaries Age 75 to 84 | 1074 |
| Number Of Beneficiaries Age Greater 84 | 474 |
| Number Of Female Beneficiaries | 2840 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 2840 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2930 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 117 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 21 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0615 |