| National Provider Identifier [NPI]: | 1346420494 |
| Last Name Of The Provider | DALSANIA |
| First Name Of The Provider | SARAJU |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1601 FAIR RD |
| Street Address 2 Of The Provider | SUITE 700 |
| City Of The Provider | STATESBORO |
| Zip Code Of The Provider | 304581698 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 7329 |
| Number Of Medicare Beneficiaries | 498 |
| Total Submitted Charge Amount | 558449 |
| Total Medicare Allowed Amount | 401477.83 |
| Total Medicare Payment Amount | 301813.42 |
| Total Medicare Standardized Payment Amount | 323702.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 950 |
| Number Of Medicare Beneficiaries With Drug Services | 332 |
| Total Drug Submitted ChargeAmount | 30576 |
| Total Drug Medicare AllowedAmount | 21222.82 |
| Total Drug Medicare PaymentAmount | 19302.76 |
| Total Drug Medicare Standardized Payment Amount | 19302.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 6379 |
| Number Of Medicare Beneficiaries With Medical Services | 498 |
| Total Medical Submitted Charge Amount | 527873 |
| Total Medical Medicare Allowed Amount | 380255.01 |
| Total Medical Medicare Payment Amount | 282510.66 |
| Total Medical Medicare Standardized Payment Amount | 304400.05 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 170 |
| Number Of Beneficiaries Age Greater 84 | 101 |
| Number Of Female Beneficiaries | 303 |
| Number Of Male Beneficiaries | 195 |
| Number Of Non Hispanic White Beneficiaries | 441 |
| 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 | 458 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 40 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1815 |