| National Provider Identifier [NPI]: | 1629215371 |
| Last Name Of The Provider | SUDHAKAR |
| First Name Of The Provider | RAJEEV |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 E CANFIELD ST |
| Street Address 2 Of The Provider | GENERAL MEDICINE AMBULATORY PRACTICE |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482011804 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 321 |
| Number Of Medicare Beneficiaries | 189 |
| Total Submitted Charge Amount | 74843 |
| Total Medicare Allowed Amount | 31938.59 |
| Total Medicare Payment Amount | 24669.11 |
| Total Medicare Standardized Payment Amount | 24030.46 |
| 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 | 21 |
| Number Of Medical Services | 321 |
| Number Of Medicare Beneficiaries With Medical Services | 189 |
| Total Medical Submitted Charge Amount | 74843 |
| Total Medical Medicare Allowed Amount | 31938.59 |
| Total Medical Medicare Payment Amount | 24669.11 |
| Total Medical Medicare Standardized Payment Amount | 24030.46 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 33 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 100 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 156 |
| 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 | 62 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 29 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 61 |
| Percent Of With Chronic Kidney Disease | 66 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 3.7606 |