| National Provider Identifier [NPI]: | 1164479911 |
| Last Name Of The Provider | JOLLY |
| First Name Of The Provider | SURINDAR |
| 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 | 4020 VENOY RD |
| Street Address 2 Of The Provider | STE#800 |
| City Of The Provider | WAYNE |
| Zip Code Of The Provider | 481841869 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 5206 |
| Number Of Medicare Beneficiaries | 1216 |
| Total Submitted Charge Amount | 922594.59 |
| Total Medicare Allowed Amount | 636166.15 |
| Total Medicare Payment Amount | 495957.71 |
| Total Medicare Standardized Payment Amount | 466163.28 |
| 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 | 26 |
| Number Of Medical Services | 5206 |
| Number Of Medicare Beneficiaries With Medical Services | 1216 |
| Total Medical Submitted Charge Amount | 922594.59 |
| Total Medical Medicare Allowed Amount | 636166.15 |
| Total Medical Medicare Payment Amount | 495957.71 |
| Total Medical Medicare Standardized Payment Amount | 466163.28 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 411 |
| Number Of Beneficiaries Age 65 to 74 | 346 |
| Number Of Beneficiaries Age 75 to 84 | 284 |
| Number Of Beneficiaries Age Greater 84 | 175 |
| Number Of Female Beneficiaries | 699 |
| Number Of Male Beneficiaries | 517 |
| Number Of Non Hispanic White Beneficiaries | 788 |
| Number Of Black or African American Beneficiaries | 351 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 749 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 467 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 30 |
| Average HCC Risk Score Of Beneficiaries | 2.0443 |