| National Provider Identifier [NPI]: | 1730105743 |
| Last Name Of The Provider | SU |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11110 MEDICAL CAMPUS RD |
| Street Address 2 Of The Provider | SUITE 127 |
| City Of The Provider | HAGERSTOWN |
| Zip Code Of The Provider | 21742 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 214 |
| Number Of Services | 12958 |
| Number Of Medicare Beneficiaries | 1678 |
| Total Submitted Charge Amount | 3445201.08 |
| Total Medicare Allowed Amount | 1528750.01 |
| Total Medicare Payment Amount | 1174623.4 |
| Total Medicare Standardized Payment Amount | 1150482.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 7042 |
| Number Of Medicare Beneficiaries With Drug Services | 136 |
| Total Drug Submitted ChargeAmount | 7069.63 |
| Total Drug Medicare AllowedAmount | 1346.51 |
| Total Drug Medicare PaymentAmount | 1054.1 |
| Total Drug Medicare Standardized Payment Amount | 1054.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 208 |
| Number Of Medical Services | 5916 |
| Number Of Medicare Beneficiaries With Medical Services | 1678 |
| Total Medical Submitted Charge Amount | 3438131.45 |
| Total Medical Medicare Allowed Amount | 1527403.5 |
| Total Medical Medicare Payment Amount | 1173569.3 |
| Total Medical Medicare Standardized Payment Amount | 1149428.41 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 265 |
| Number Of Beneficiaries Age 65 to 74 | 601 |
| Number Of Beneficiaries Age 75 to 84 | 566 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 870 |
| Number Of Male Beneficiaries | 808 |
| Number Of Non Hispanic White Beneficiaries | 1577 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1326 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 352 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.6627 |