| National Provider Identifier [NPI]: | 1669480224 |
| Last Name Of The Provider | VIJAYAKUMARAN |
| First Name Of The Provider | PUTHENPARAMPIL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 33101 ANNAPOLIS |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | WAYNE |
| Zip Code Of The Provider | 481842405 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 1362 |
| Number Of Medicare Beneficiaries | 149 |
| Total Submitted Charge Amount | 64933.57 |
| Total Medicare Allowed Amount | 39017.5 |
| Total Medicare Payment Amount | 27520.17 |
| Total Medicare Standardized Payment Amount | 27378.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 774 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 5648.57 |
| Total Drug Medicare AllowedAmount | 5648.48 |
| Total Drug Medicare PaymentAmount | 4410.79 |
| Total Drug Medicare Standardized Payment Amount | 4410.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 588 |
| Number Of Medicare Beneficiaries With Medical Services | 149 |
| Total Medical Submitted Charge Amount | 59285 |
| Total Medical Medicare Allowed Amount | 33369.02 |
| Total Medical Medicare Payment Amount | 23109.38 |
| Total Medical Medicare Standardized Payment Amount | 22967.87 |
| Average Age Of Beneficiaries | 50 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 79 |
| Number Of Male Beneficiaries | 70 |
| Number Of Non Hispanic White Beneficiaries | 93 |
| 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 | 25 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 66 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 59 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2904 |