| National Provider Identifier [NPI]: | 1871506972 |
| Last Name Of The Provider | JAIN |
| First Name Of The Provider | RAJ |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 124 W PITKIN AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUEBLO |
| Zip Code Of The Provider | 810042021 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 284 |
| Number Of Services | 6038 |
| Number Of Medicare Beneficiaries | 3329 |
| Total Submitted Charge Amount | 989873.75 |
| Total Medicare Allowed Amount | 267714.79 |
| Total Medicare Payment Amount | 199521.88 |
| Total Medicare Standardized Payment Amount | 200343.4 |
| 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 | 284 |
| Number Of Medical Services | 6038 |
| Number Of Medicare Beneficiaries With Medical Services | 3329 |
| Total Medical Submitted Charge Amount | 989873.75 |
| Total Medical Medicare Allowed Amount | 267714.79 |
| Total Medical Medicare Payment Amount | 199521.88 |
| Total Medical Medicare Standardized Payment Amount | 200343.4 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 784 |
| Number Of Beneficiaries Age 65 to 74 | 1149 |
| Number Of Beneficiaries Age 75 to 84 | 878 |
| Number Of Beneficiaries Age Greater 84 | 518 |
| Number Of Female Beneficiaries | 1912 |
| Number Of Male Beneficiaries | 1417 |
| Number Of Non Hispanic White Beneficiaries | 2414 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 835 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2281 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1048 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.652 |