| National Provider Identifier [NPI]: | 1982661534 |
| Last Name Of The Provider | VERGHESE |
| First Name Of The Provider | SURESH |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11701 LIVINGSTON RD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FORT WASHINGTON |
| Zip Code Of The Provider | 207445104 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4694 |
| Number Of Medicare Beneficiaries | 462 |
| Total Submitted Charge Amount | 388158.04 |
| Total Medicare Allowed Amount | 215061.54 |
| Total Medicare Payment Amount | 156476.56 |
| Total Medicare Standardized Payment Amount | 142132.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 114 |
| Number Of Medicare Beneficiaries With Drug Services | 103 |
| Total Drug Submitted ChargeAmount | 3118 |
| Total Drug Medicare AllowedAmount | 1702.97 |
| Total Drug Medicare PaymentAmount | 1662.91 |
| Total Drug Medicare Standardized Payment Amount | 1662.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 4580 |
| Number Of Medicare Beneficiaries With Medical Services | 462 |
| Total Medical Submitted Charge Amount | 385040.04 |
| Total Medical Medicare Allowed Amount | 213358.57 |
| Total Medical Medicare Payment Amount | 154813.65 |
| Total Medical Medicare Standardized Payment Amount | 140470.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 213 |
| Number Of Beneficiaries Age 75 to 84 | 165 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 256 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 168 |
| Number Of Black or African American Beneficiaries | 251 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| 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 | 444 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 5 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9687 |