| National Provider Identifier [NPI]: | 1174784839 |
| Last Name Of The Provider | RAGHAVAN |
| First Name Of The Provider | DEEPAK |
| 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 | 1001 SAM PERRY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224014453 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 145 |
| Number Of Services | 9931 |
| Number Of Medicare Beneficiaries | 1824 |
| Total Submitted Charge Amount | 1921774.2 |
| Total Medicare Allowed Amount | 308561.7 |
| Total Medicare Payment Amount | 238370.23 |
| Total Medicare Standardized Payment Amount | 245159.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7454 |
| Number Of Medicare Beneficiaries With Drug Services | 202 |
| Total Drug Submitted ChargeAmount | 39000 |
| Total Drug Medicare AllowedAmount | 4860.15 |
| Total Drug Medicare PaymentAmount | 3781.51 |
| Total Drug Medicare Standardized Payment Amount | 3781.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 142 |
| Number Of Medical Services | 2477 |
| Number Of Medicare Beneficiaries With Medical Services | 1824 |
| Total Medical Submitted Charge Amount | 1882774.2 |
| Total Medical Medicare Allowed Amount | 303701.55 |
| Total Medical Medicare Payment Amount | 234588.72 |
| Total Medical Medicare Standardized Payment Amount | 241378.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 290 |
| Number Of Beneficiaries Age 65 to 74 | 691 |
| Number Of Beneficiaries Age 75 to 84 | 587 |
| Number Of Beneficiaries Age Greater 84 | 256 |
| Number Of Female Beneficiaries | 1071 |
| Number Of Male Beneficiaries | 753 |
| Number Of Non Hispanic White Beneficiaries | 1524 |
| Number Of Black or African American Beneficiaries | 239 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1494 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 330 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.6281 |