| National Provider Identifier [NPI]: | 1164737581 |
| Last Name Of The Provider | SUKHAREV |
| First Name Of The Provider | DINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2400 SAMARITAN DR |
| Street Address 2 Of The Provider | STE 203 |
| City Of The Provider | SAN JOSE |
| Zip Code Of The Provider | 951243910 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 290 |
| Number Of Medicare Beneficiaries | 143 |
| Total Submitted Charge Amount | 55352 |
| Total Medicare Allowed Amount | 24368.45 |
| Total Medicare Payment Amount | 17390.64 |
| Total Medicare Standardized Payment Amount | 14790.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 698 |
| Total Drug Medicare AllowedAmount | 491.59 |
| Total Drug Medicare PaymentAmount | 478.09 |
| Total Drug Medicare Standardized Payment Amount | 478.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 263 |
| Number Of Medicare Beneficiaries With Medical Services | 143 |
| Total Medical Submitted Charge Amount | 54654 |
| Total Medical Medicare Allowed Amount | 23876.86 |
| Total Medical Medicare Payment Amount | 16912.55 |
| Total Medical Medicare Standardized Payment Amount | 14311.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | 121 |
| 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 | 120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9467 |