| National Provider Identifier [NPI]: | 1124042007 |
| Last Name Of The Provider | RAO |
| First Name Of The Provider | SUDEEP |
| 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 | 3301 KNOLLWOOD DR |
| Street Address 2 Of The Provider | MED PARK FOUR |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366937003 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 107 |
| Number Of Services | 2698 |
| Number Of Medicare Beneficiaries | 481 |
| Total Submitted Charge Amount | 185219 |
| Total Medicare Allowed Amount | 125841.33 |
| Total Medicare Payment Amount | 91386.41 |
| Total Medicare Standardized Payment Amount | 100825.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 309 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 2378 |
| Total Drug Medicare AllowedAmount | 1110.75 |
| Total Drug Medicare PaymentAmount | 968.4 |
| Total Drug Medicare Standardized Payment Amount | 968.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 2389 |
| Number Of Medicare Beneficiaries With Medical Services | 481 |
| Total Medical Submitted Charge Amount | 182841 |
| Total Medical Medicare Allowed Amount | 124730.58 |
| Total Medical Medicare Payment Amount | 90418.01 |
| Total Medical Medicare Standardized Payment Amount | 99856.74 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 309 |
| Number Of Male Beneficiaries | 172 |
| Number Of Non Hispanic White Beneficiaries | 291 |
| 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 | 397 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5766 |