| National Provider Identifier [NPI]: | 1902950702 |
| Last Name Of The Provider | KITTUSAMY |
| First Name Of The Provider | BHUVANESWARI |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7500 SMOKE RANCH RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891280324 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 17735 |
| Number Of Medicare Beneficiaries | 1206 |
| Total Submitted Charge Amount | 1679788 |
| Total Medicare Allowed Amount | 372602.84 |
| Total Medicare Payment Amount | 280738.43 |
| Total Medicare Standardized Payment Amount | 279352.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 15630 |
| Number Of Medicare Beneficiaries With Drug Services | 178 |
| Total Drug Submitted ChargeAmount | 17673 |
| Total Drug Medicare AllowedAmount | 3279.18 |
| Total Drug Medicare PaymentAmount | 2570.73 |
| Total Drug Medicare Standardized Payment Amount | 2570.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 2105 |
| Number Of Medicare Beneficiaries With Medical Services | 1206 |
| Total Medical Submitted Charge Amount | 1662115 |
| Total Medical Medicare Allowed Amount | 369323.66 |
| Total Medical Medicare Payment Amount | 278167.7 |
| Total Medical Medicare Standardized Payment Amount | 276781.71 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 392 |
| Number Of Beneficiaries Age 65 to 74 | 528 |
| Number Of Beneficiaries Age 75 to 84 | 227 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 735 |
| Number Of Male Beneficiaries | 471 |
| Number Of Non Hispanic White Beneficiaries | 770 |
| Number Of Black or African American Beneficiaries | 193 |
| Number Of AsianPacific Islander Beneficiaries | 71 |
| Number Of Hispanic Beneficiaries | 139 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 867 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 339 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4307 |