| National Provider Identifier [NPI]: | 1417085606 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3098 CAMPBELL STATION PKWY |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | SPRING HILL |
| Zip Code Of The Provider | 371746270 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Allergy/Immunology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 5091 |
| Number Of Medicare Beneficiaries | 407 |
| Total Submitted Charge Amount | 224073 |
| Total Medicare Allowed Amount | 119071.49 |
| Total Medicare Payment Amount | 86852.37 |
| Total Medicare Standardized Payment Amount | 92098.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 76 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 152 |
| Total Drug Medicare AllowedAmount | 135.54 |
| Total Drug Medicare PaymentAmount | 91.99 |
| Total Drug Medicare Standardized Payment Amount | 91.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 5015 |
| Number Of Medicare Beneficiaries With Medical Services | 407 |
| Total Medical Submitted Charge Amount | 223921 |
| Total Medical Medicare Allowed Amount | 118935.95 |
| Total Medical Medicare Payment Amount | 86760.38 |
| Total Medical Medicare Standardized Payment Amount | 92006.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 186 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 208 |
| Number Of Male Beneficiaries | 199 |
| Number Of Non Hispanic White Beneficiaries | 395 |
| 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 | 372 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0096 |