| National Provider Identifier [NPI]: | 1134179922 |
| Last Name Of The Provider | MARATHE |
| First Name Of The Provider | SHRIRAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 665 STATE ROAD 207 |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | SAINT AUGUSTINE |
| Zip Code Of The Provider | 320845938 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 5858 |
| Number Of Medicare Beneficiaries | 988 |
| Total Submitted Charge Amount | 989390.13 |
| Total Medicare Allowed Amount | 583940.5 |
| Total Medicare Payment Amount | 437974.9 |
| Total Medicare Standardized Payment Amount | 437634.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 612 |
| Number Of Medicare Beneficiaries With Drug Services | 201 |
| Total Drug Submitted ChargeAmount | 12211 |
| Total Drug Medicare AllowedAmount | 3340.28 |
| Total Drug Medicare PaymentAmount | 3075.53 |
| Total Drug Medicare Standardized Payment Amount | 3075.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 5246 |
| Number Of Medicare Beneficiaries With Medical Services | 988 |
| Total Medical Submitted Charge Amount | 977179.13 |
| Total Medical Medicare Allowed Amount | 580600.22 |
| Total Medical Medicare Payment Amount | 434899.37 |
| Total Medical Medicare Standardized Payment Amount | 434559.03 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 358 |
| Number Of Beneficiaries Age 65 to 74 | 305 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 557 |
| Number Of Male Beneficiaries | 431 |
| Number Of Non Hispanic White Beneficiaries | 707 |
| Number Of Black or African American Beneficiaries | 203 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 433 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 555 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8962 |