| National Provider Identifier [NPI]: | 1437137478 |
| Last Name Of The Provider | SUNDRAM |
| First Name Of The Provider | PONNAMBALAM |
| 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 | 71 W 156TH ST |
| Street Address 2 Of The Provider | STE 305 |
| City Of The Provider | HARVEY |
| Zip Code Of The Provider | 604264260 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 12760 |
| Number Of Medicare Beneficiaries | 1249 |
| Total Submitted Charge Amount | 2091968 |
| Total Medicare Allowed Amount | 855675.69 |
| Total Medicare Payment Amount | 658605.35 |
| Total Medicare Standardized Payment Amount | 626071.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7078 |
| Number Of Medicare Beneficiaries With Drug Services | 153 |
| Total Drug Submitted ChargeAmount | 35425 |
| Total Drug Medicare AllowedAmount | 20145.45 |
| Total Drug Medicare PaymentAmount | 15093.97 |
| Total Drug Medicare Standardized Payment Amount | 15093.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 5682 |
| Number Of Medicare Beneficiaries With Medical Services | 1248 |
| Total Medical Submitted Charge Amount | 2056543 |
| Total Medical Medicare Allowed Amount | 835530.24 |
| Total Medical Medicare Payment Amount | 643511.38 |
| Total Medical Medicare Standardized Payment Amount | 610977.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 159 |
| Number Of Beneficiaries Age 65 to 74 | 435 |
| Number Of Beneficiaries Age 75 to 84 | 409 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 703 |
| Number Of Male Beneficiaries | 546 |
| Number Of Non Hispanic White Beneficiaries | 713 |
| Number Of Black or African American Beneficiaries | 484 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 972 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 277 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9496 |