| National Provider Identifier [NPI]: | 1154424182 |
| Last Name Of The Provider | SUDOL |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 408 E JIMMIE LEEDS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | GALLOWAY |
| Zip Code Of The Provider | 082059706 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 15508 |
| Number Of Medicare Beneficiaries | 673 |
| Total Submitted Charge Amount | 830757.64 |
| Total Medicare Allowed Amount | 499008.8 |
| Total Medicare Payment Amount | 388299.91 |
| Total Medicare Standardized Payment Amount | 368268.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 2254 |
| Number Of Medicare Beneficiaries With Drug Services | 258 |
| Total Drug Submitted ChargeAmount | 132066.64 |
| Total Drug Medicare AllowedAmount | 36277.19 |
| Total Drug Medicare PaymentAmount | 29805.32 |
| Total Drug Medicare Standardized Payment Amount | 29805.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 13254 |
| Number Of Medicare Beneficiaries With Medical Services | 673 |
| Total Medical Submitted Charge Amount | 698691 |
| Total Medical Medicare Allowed Amount | 462731.61 |
| Total Medical Medicare Payment Amount | 358494.59 |
| Total Medical Medicare Standardized Payment Amount | 338462.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 312 |
| Number Of Beneficiaries Age 75 to 84 | 236 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 347 |
| Number Of Male Beneficiaries | 326 |
| Number Of Non Hispanic White Beneficiaries | 577 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 643 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2766 |