| National Provider Identifier [NPI]: | 1861475170 |
| Last Name Of The Provider | DISSANAYAKE |
| First Name Of The Provider | RANJITH |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8333 N DAVIS HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | PENSACOLA |
| Zip Code Of The Provider | 325146050 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 2499 |
| Number Of Medicare Beneficiaries | 610 |
| Total Submitted Charge Amount | 219210.69 |
| Total Medicare Allowed Amount | 175581.16 |
| Total Medicare Payment Amount | 133354.2 |
| Total Medicare Standardized Payment Amount | 132552.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 2499 |
| Number Of Medicare Beneficiaries With Medical Services | 610 |
| Total Medical Submitted Charge Amount | 219210.69 |
| Total Medical Medicare Allowed Amount | 175581.16 |
| Total Medical Medicare Payment Amount | 133354.2 |
| Total Medical Medicare Standardized Payment Amount | 132552.08 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 84 |
| Number Of Beneficiaries Age 65 to 74 | 251 |
| Number Of Beneficiaries Age 75 to 84 | 203 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 331 |
| Number Of Male Beneficiaries | 279 |
| Number Of Non Hispanic White Beneficiaries | 503 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 519 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 91 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 38 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9755 |