| National Provider Identifier [NPI]: | 1053390112 |
| Last Name Of The Provider | SAMUDRALA |
| First Name Of The Provider | ROJANANDHAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 36175 HARPER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLINTON TOWNSHIP |
| Zip Code Of The Provider | 480353274 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 3711 |
| Number Of Medicare Beneficiaries | 2735 |
| Total Submitted Charge Amount | 276036 |
| Total Medicare Allowed Amount | 123877.05 |
| Total Medicare Payment Amount | 93462.47 |
| Total Medicare Standardized Payment Amount | 91386.93 |
| 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 | 173 |
| Number Of Medical Services | 3711 |
| Number Of Medicare Beneficiaries With Medical Services | 2735 |
| Total Medical Submitted Charge Amount | 276036 |
| Total Medical Medicare Allowed Amount | 123877.05 |
| Total Medical Medicare Payment Amount | 93462.47 |
| Total Medical Medicare Standardized Payment Amount | 91386.93 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 745 |
| Number Of Beneficiaries Age 65 to 74 | 874 |
| Number Of Beneficiaries Age 75 to 84 | 690 |
| Number Of Beneficiaries Age Greater 84 | 426 |
| Number Of Female Beneficiaries | 1535 |
| Number Of Male Beneficiaries | 1200 |
| Number Of Non Hispanic White Beneficiaries | 1440 |
| Number Of Black or African American Beneficiaries | 1226 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1766 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 969 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.6114 |