| National Provider Identifier [NPI]: | 1881786689 |
| Last Name Of The Provider | SURI |
| First Name Of The Provider | PROMILA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 155 W HIGH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ELKTON |
| Zip Code Of The Provider | 219215526 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Medical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 16056 |
| Number Of Medicare Beneficiaries | 117 |
| Total Submitted Charge Amount | 432438 |
| Total Medicare Allowed Amount | 283581.5 |
| Total Medicare Payment Amount | 220682.06 |
| Total Medicare Standardized Payment Amount | 217978.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 28 |
| Number Of Drug Services | 15089 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 287679 |
| Total Drug Medicare AllowedAmount | 206248.66 |
| Total Drug Medicare PaymentAmount | 161641.53 |
| Total Drug Medicare Standardized Payment Amount | 161641.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 967 |
| Number Of Medicare Beneficiaries With Medical Services | 117 |
| Total Medical Submitted Charge Amount | 144759 |
| Total Medical Medicare Allowed Amount | 77332.84 |
| Total Medical Medicare Payment Amount | 59040.53 |
| Total Medical Medicare Standardized Payment Amount | 56336.49 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 38 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 84 |
| Number Of Male Beneficiaries | 33 |
| Number Of Non Hispanic White Beneficiaries | 88 |
| 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 | 90 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5693 |