| National Provider Identifier [NPI]: | 1649242892 |
| Last Name Of The Provider | VIRAPONGSE |
| First Name Of The Provider | CHATRACHIA |
| 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 | 1600 LAKELAND HILLS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKELAND |
| Zip Code Of The Provider | 33805 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 7824 |
| Number Of Medicare Beneficiaries | 1163 |
| Total Submitted Charge Amount | 527667 |
| Total Medicare Allowed Amount | 148268.62 |
| Total Medicare Payment Amount | 104283.43 |
| Total Medicare Standardized Payment Amount | 108147.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6431 |
| Number Of Medicare Beneficiaries With Drug Services | 81 |
| Total Drug Submitted ChargeAmount | 12895 |
| Total Drug Medicare AllowedAmount | 2668.01 |
| Total Drug Medicare PaymentAmount | 2091.9 |
| Total Drug Medicare Standardized Payment Amount | 2091.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 1393 |
| Number Of Medicare Beneficiaries With Medical Services | 1158 |
| Total Medical Submitted Charge Amount | 514772 |
| Total Medical Medicare Allowed Amount | 145600.61 |
| Total Medical Medicare Payment Amount | 102191.53 |
| Total Medical Medicare Standardized Payment Amount | 106055.66 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 403 |
| Number Of Beneficiaries Age 75 to 84 | 449 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 713 |
| Number Of Male Beneficiaries | 450 |
| Number Of Non Hispanic White Beneficiaries | 1061 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1029 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5369 |