| National Provider Identifier [NPI]: | 1811224561 |
| Last Name Of The Provider | SELVARAJAN |
| First Name Of The Provider | SANTOSH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 S 11TH ST |
| Street Address 2 Of The Provider | STE 3390 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191074824 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 5118 |
| Number Of Medicare Beneficiaries | 1971 |
| Total Submitted Charge Amount | 754213.5 |
| Total Medicare Allowed Amount | 133225.67 |
| Total Medicare Payment Amount | 96094.44 |
| Total Medicare Standardized Payment Amount | 94281.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1385 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 3240.9 |
| Total Drug Medicare AllowedAmount | 255.93 |
| Total Drug Medicare PaymentAmount | 173.78 |
| Total Drug Medicare Standardized Payment Amount | 173.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 3733 |
| Number Of Medicare Beneficiaries With Medical Services | 1971 |
| Total Medical Submitted Charge Amount | 750972.6 |
| Total Medical Medicare Allowed Amount | 132969.74 |
| Total Medical Medicare Payment Amount | 95920.66 |
| Total Medical Medicare Standardized Payment Amount | 94107.29 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 595 |
| Number Of Beneficiaries Age 65 to 74 | 621 |
| Number Of Beneficiaries Age 75 to 84 | 459 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 1063 |
| Number Of Male Beneficiaries | 908 |
| Number Of Non Hispanic White Beneficiaries | 1201 |
| Number Of Black or African American Beneficiaries | 603 |
| Number Of AsianPacific Islander Beneficiaries | 93 |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1145 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 826 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.3338 |