| National Provider Identifier [NPI]: | 1407858228 |
| Last Name Of The Provider | CHOUDHARY |
| First Name Of The Provider | SANJAY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7215 OLD OAK BLVD |
| Street Address 2 Of The Provider | SUITE A420 |
| City Of The Provider | MIDDLEBURG HEIGHTS |
| Zip Code Of The Provider | 441303340 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 5608 |
| Number Of Medicare Beneficiaries | 675 |
| Total Submitted Charge Amount | 789051 |
| Total Medicare Allowed Amount | 459823.03 |
| Total Medicare Payment Amount | 354754.87 |
| Total Medicare Standardized Payment Amount | 361673.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 397 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 5416 |
| Total Drug Medicare AllowedAmount | 2440.48 |
| Total Drug Medicare PaymentAmount | 1919.76 |
| Total Drug Medicare Standardized Payment Amount | 1919.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 5211 |
| Number Of Medicare Beneficiaries With Medical Services | 675 |
| Total Medical Submitted Charge Amount | 783635 |
| Total Medical Medicare Allowed Amount | 457382.55 |
| Total Medical Medicare Payment Amount | 352835.11 |
| Total Medical Medicare Standardized Payment Amount | 359754.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 131 |
| Number Of Beneficiaries Age 65 to 74 | 177 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 166 |
| Number Of Female Beneficiaries | 396 |
| Number Of Male Beneficiaries | 279 |
| Number Of Non Hispanic White Beneficiaries | 615 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 432 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 243 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 24 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4638 |