| National Provider Identifier [NPI]: | 1497918791 |
| Last Name Of The Provider | PRABHU |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2850 N RIDGE RD STE 103 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELLICOTT CITY |
| Zip Code Of The Provider | 210433396 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 464 |
| Number Of Medicare Beneficiaries | 160 |
| Total Submitted Charge Amount | 70287.5 |
| Total Medicare Allowed Amount | 37523.05 |
| Total Medicare Payment Amount | 27149.86 |
| Total Medicare Standardized Payment Amount | 25848.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 1928 |
| Total Drug Medicare AllowedAmount | 1220.41 |
| Total Drug Medicare PaymentAmount | 1187.6 |
| Total Drug Medicare Standardized Payment Amount | 1187.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 428 |
| Number Of Medicare Beneficiaries With Medical Services | 160 |
| Total Medical Submitted Charge Amount | 68359.5 |
| Total Medical Medicare Allowed Amount | 36302.64 |
| Total Medical Medicare Payment Amount | 25962.26 |
| Total Medical Medicare Standardized Payment Amount | 24661.09 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 36 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 112 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | 122 |
| 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 | 137 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.87 |