| National Provider Identifier [NPI]: | 1730164724 |
| Last Name Of The Provider | GHAVAMI |
| First Name Of The Provider | RICHARD |
| 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 | 1106 DRUID RD S |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563846 |
| 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 | 193 |
| Number Of Services | 11811 |
| Number Of Medicare Beneficiaries | 4027 |
| Total Submitted Charge Amount | 1125373.49 |
| Total Medicare Allowed Amount | 249000.03 |
| Total Medicare Payment Amount | 191196.83 |
| Total Medicare Standardized Payment Amount | 193067.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5720 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 14795.6 |
| Total Drug Medicare AllowedAmount | 2142.24 |
| Total Drug Medicare PaymentAmount | 1664.92 |
| Total Drug Medicare Standardized Payment Amount | 1664.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 190 |
| Number Of Medical Services | 6091 |
| Number Of Medicare Beneficiaries With Medical Services | 4027 |
| Total Medical Submitted Charge Amount | 1110577.89 |
| Total Medical Medicare Allowed Amount | 246857.79 |
| Total Medical Medicare Payment Amount | 189531.91 |
| Total Medical Medicare Standardized Payment Amount | 191403.06 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 490 |
| Number Of Beneficiaries Age 65 to 74 | 1205 |
| Number Of Beneficiaries Age 75 to 84 | 1286 |
| Number Of Beneficiaries Age Greater 84 | 1046 |
| Number Of Female Beneficiaries | 2432 |
| Number Of Male Beneficiaries | 1595 |
| Number Of Non Hispanic White Beneficiaries | 3704 |
| Number Of Black or African American Beneficiaries | 108 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 143 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3154 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 873 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 1.9283 |