| National Provider Identifier [NPI]: | 1376532556 |
| Last Name Of The Provider | RAJ |
| First Name Of The Provider | ETHIRAJ |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1165 S LINDEN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FLINT |
| Zip Code Of The Provider | 485323406 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 30777 |
| Number Of Medicare Beneficiaries | 2350 |
| Total Submitted Charge Amount | 2204379.72 |
| Total Medicare Allowed Amount | 1006438.25 |
| Total Medicare Payment Amount | 766888.08 |
| Total Medicare Standardized Payment Amount | 801655.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 22681 |
| Number Of Medicare Beneficiaries With Drug Services | 510 |
| Total Drug Submitted ChargeAmount | 149376 |
| Total Drug Medicare AllowedAmount | 73384.03 |
| Total Drug Medicare PaymentAmount | 57397.76 |
| Total Drug Medicare Standardized Payment Amount | 57397.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 8096 |
| Number Of Medicare Beneficiaries With Medical Services | 2349 |
| Total Medical Submitted Charge Amount | 2055003.72 |
| Total Medical Medicare Allowed Amount | 933054.22 |
| Total Medical Medicare Payment Amount | 709490.32 |
| Total Medical Medicare Standardized Payment Amount | 744257.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 348 |
| Number Of Beneficiaries Age 65 to 74 | 836 |
| Number Of Beneficiaries Age 75 to 84 | 746 |
| Number Of Beneficiaries Age Greater 84 | 420 |
| Number Of Female Beneficiaries | 1224 |
| Number Of Male Beneficiaries | 1126 |
| Number Of Non Hispanic White Beneficiaries | 1587 |
| Number Of Black or African American Beneficiaries | 676 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1997 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 353 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.844 |