| National Provider Identifier [NPI]: | 1083775670 |
| Last Name Of The Provider | KEOMAHATHAI |
| First Name Of The Provider | SACKDINANH |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 REDMOND RD NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROME |
| Zip Code Of The Provider | 301651416 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 8543 |
| Number Of Medicare Beneficiaries | 1346 |
| Total Submitted Charge Amount | 1392492 |
| Total Medicare Allowed Amount | 531911.72 |
| Total Medicare Payment Amount | 359390.03 |
| Total Medicare Standardized Payment Amount | 388659.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 4036 |
| Number Of Medicare Beneficiaries With Drug Services | 303 |
| Total Drug Submitted ChargeAmount | 69981 |
| Total Drug Medicare AllowedAmount | 15207.91 |
| Total Drug Medicare PaymentAmount | 9566.25 |
| Total Drug Medicare Standardized Payment Amount | 9566.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 4507 |
| Number Of Medicare Beneficiaries With Medical Services | 1346 |
| Total Medical Submitted Charge Amount | 1322511 |
| Total Medical Medicare Allowed Amount | 516703.81 |
| Total Medical Medicare Payment Amount | 349823.78 |
| Total Medical Medicare Standardized Payment Amount | 379093.46 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 683 |
| Number Of Beneficiaries Age 65 to 74 | 431 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 798 |
| Number Of Male Beneficiaries | 548 |
| Number Of Non Hispanic White Beneficiaries | 1205 |
| Number Of Black or African American Beneficiaries | 116 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 837 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 509 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.2824 |