| National Provider Identifier [NPI]: | 1356349781 |
| Last Name Of The Provider | KUPPUSAMY |
| First Name Of The Provider | TAMIL |
| 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 | 516 N ROLLING RD |
| Street Address 2 Of The Provider | SUITE 304 |
| City Of The Provider | CATONSVILLE |
| Zip Code Of The Provider | 212284140 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 6497 |
| Number Of Medicare Beneficiaries | 788 |
| Total Submitted Charge Amount | 1242409.74 |
| Total Medicare Allowed Amount | 496095.67 |
| Total Medicare Payment Amount | 376016.02 |
| Total Medicare Standardized Payment Amount | 360564.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2849 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 81976.38 |
| Total Drug Medicare AllowedAmount | 32746.78 |
| Total Drug Medicare PaymentAmount | 25524.42 |
| Total Drug Medicare Standardized Payment Amount | 25524.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 3648 |
| Number Of Medicare Beneficiaries With Medical Services | 788 |
| Total Medical Submitted Charge Amount | 1160433.36 |
| Total Medical Medicare Allowed Amount | 463348.89 |
| Total Medical Medicare Payment Amount | 350491.6 |
| Total Medical Medicare Standardized Payment Amount | 335039.59 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 219 |
| Number Of Beneficiaries Age 65 to 74 | 225 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 111 |
| Number Of Female Beneficiaries | 381 |
| Number Of Male Beneficiaries | 407 |
| Number Of Non Hispanic White Beneficiaries | 276 |
| Number Of Black or African American Beneficiaries | 491 |
| 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 | 548 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 240 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 4.6242 |