| National Provider Identifier [NPI]: | 1710971387 |
| Last Name Of The Provider | SIVASAILAM |
| First Name Of The Provider | SANKARAVADIVU |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9114 PHILADELPHIA RD |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212374317 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 32828 |
| Number Of Medicare Beneficiaries | 733 |
| Total Submitted Charge Amount | 1500113 |
| Total Medicare Allowed Amount | 872109.88 |
| Total Medicare Payment Amount | 673199.12 |
| Total Medicare Standardized Payment Amount | 665458.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 44 |
| Number Of Drug Services | 28500 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 1036196 |
| Total Drug Medicare AllowedAmount | 638445.83 |
| Total Drug Medicare PaymentAmount | 494897.32 |
| Total Drug Medicare Standardized Payment Amount | 494897.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 4328 |
| Number Of Medicare Beneficiaries With Medical Services | 733 |
| Total Medical Submitted Charge Amount | 463917 |
| Total Medical Medicare Allowed Amount | 233664.05 |
| Total Medical Medicare Payment Amount | 178301.8 |
| Total Medical Medicare Standardized Payment Amount | 170561.48 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 65 |
| Number Of Beneficiaries Age 65 to 74 | 323 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 528 |
| Number Of Male Beneficiaries | 205 |
| Number Of Non Hispanic White Beneficiaries | 644 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 652 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 56 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7832 |