| National Provider Identifier [NPI]: | 1568531424 |
| Last Name Of The Provider | SASTRY |
| First Name Of The Provider | SANJAY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 BEVILLE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH DAYTONA |
| Zip Code Of The Provider | 321191860 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 236 |
| Number Of Medicare Beneficiaries | 35 |
| Total Submitted Charge Amount | 40310 |
| Total Medicare Allowed Amount | 8787.26 |
| Total Medicare Payment Amount | 6889.16 |
| Total Medicare Standardized Payment Amount | 6748.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 153 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 4225 |
| Total Drug Medicare AllowedAmount | 502.4 |
| Total Drug Medicare PaymentAmount | 393.94 |
| Total Drug Medicare Standardized Payment Amount | 393.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 83 |
| Number Of Medicare Beneficiaries With Medical Services | 35 |
| Total Medical Submitted Charge Amount | 36085 |
| Total Medical Medicare Allowed Amount | 8284.86 |
| Total Medical Medicare Payment Amount | 6495.22 |
| Total Medical Medicare Standardized Payment Amount | 6354.15 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 15 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 24 |
| Number Of Male Beneficiaries | 11 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3883 |