| National Provider Identifier [NPI]: | 1285682450 |
| Last Name Of The Provider | BASU |
| First Name Of The Provider | SANJAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 GROTON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | AYER |
| Zip Code Of The Provider | 014321168 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 539 |
| Number Of Medicare Beneficiaries | 206 |
| Total Submitted Charge Amount | 100166 |
| Total Medicare Allowed Amount | 41468.78 |
| Total Medicare Payment Amount | 32473.64 |
| Total Medicare Standardized Payment Amount | 30712.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 2564 |
| Total Drug Medicare AllowedAmount | 1244.17 |
| Total Drug Medicare PaymentAmount | 1219.26 |
| Total Drug Medicare Standardized Payment Amount | 1219.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 508 |
| Number Of Medicare Beneficiaries With Medical Services | 206 |
| Total Medical Submitted Charge Amount | 97602 |
| Total Medical Medicare Allowed Amount | 40224.61 |
| Total Medical Medicare Payment Amount | 31254.38 |
| Total Medical Medicare Standardized Payment Amount | 29493.17 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 184 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7293 |