| National Provider Identifier [NPI]: | 1477647097 |
| Last Name Of The Provider | AMBALAVANAR |
| First Name Of The Provider | KANDASAMY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7845 OAKWOOD ROAD |
| Street Address 2 Of The Provider | 103 |
| City Of The Provider | GLEN BURINE |
| Zip Code Of The Provider | 21061 |
| 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 | 48 |
| Number Of Services | 2586 |
| Number Of Medicare Beneficiaries | 290 |
| Total Submitted Charge Amount | 273304 |
| Total Medicare Allowed Amount | 189840.54 |
| Total Medicare Payment Amount | 142021.41 |
| Total Medicare Standardized Payment Amount | 133960.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 123 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 1905 |
| Total Drug Medicare AllowedAmount | 1901.35 |
| Total Drug Medicare PaymentAmount | 1863.32 |
| Total Drug Medicare Standardized Payment Amount | 1863.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 2463 |
| Number Of Medicare Beneficiaries With Medical Services | 290 |
| Total Medical Submitted Charge Amount | 271399 |
| Total Medical Medicare Allowed Amount | 187939.19 |
| Total Medical Medicare Payment Amount | 140158.09 |
| Total Medical Medicare Standardized Payment Amount | 132097.14 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 121 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 115 |
| Number Of Non Hispanic White Beneficiaries | 231 |
| Number Of Black or African American Beneficiaries | 45 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 238 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4427 |