| National Provider Identifier [NPI]: | 1356367163 |
| Last Name Of The Provider | KUMAR |
| First Name Of The Provider | SARVADAMAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 SMITH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | OCONTO |
| Zip Code Of The Provider | 541531080 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 2520 |
| Number Of Medicare Beneficiaries | 193 |
| Total Submitted Charge Amount | 289803.25 |
| Total Medicare Allowed Amount | 70708.03 |
| Total Medicare Payment Amount | 52984.36 |
| Total Medicare Standardized Payment Amount | 54840.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 108 |
| Number Of Medicare Beneficiaries With Drug Services | 75 |
| Total Drug Submitted ChargeAmount | 4108.75 |
| Total Drug Medicare AllowedAmount | 2507.18 |
| Total Drug Medicare PaymentAmount | 2395.14 |
| Total Drug Medicare Standardized Payment Amount | 2395.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 2412 |
| Number Of Medicare Beneficiaries With Medical Services | 193 |
| Total Medical Submitted Charge Amount | 285694.5 |
| Total Medical Medicare Allowed Amount | 68200.85 |
| Total Medical Medicare Payment Amount | 50589.22 |
| Total Medical Medicare Standardized Payment Amount | 52445.15 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 64 |
| Number Of Beneficiaries Age Greater 84 | 33 |
| Number Of Female Beneficiaries | 82 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 181 |
| Number Of Black or African American Beneficiaries | |
| 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 | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0344 |