| National Provider Identifier [NPI]: | 1649279340 |
| Last Name Of The Provider | GAINES |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 COLUMBIA ST |
| Street Address 2 Of The Provider | DRA IMAGING, P.C. |
| City Of The Provider | POUGHKEEPSIE |
| Zip Code Of The Provider | 126013923 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 246 |
| Number Of Services | 26536 |
| Number Of Medicare Beneficiaries | 6709 |
| Total Submitted Charge Amount | 1983618.7 |
| Total Medicare Allowed Amount | 549341.63 |
| Total Medicare Payment Amount | 426791.77 |
| Total Medicare Standardized Payment Amount | 411218.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 14552 |
| Number Of Medicare Beneficiaries With Drug Services | 179 |
| Total Drug Submitted ChargeAmount | 4289.54 |
| Total Drug Medicare AllowedAmount | 3028.01 |
| Total Drug Medicare PaymentAmount | 2373.75 |
| Total Drug Medicare Standardized Payment Amount | 2373.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 240 |
| Number Of Medical Services | 11984 |
| Number Of Medicare Beneficiaries With Medical Services | 6709 |
| Total Medical Submitted Charge Amount | 1979329.16 |
| Total Medical Medicare Allowed Amount | 546313.62 |
| Total Medical Medicare Payment Amount | 424418.02 |
| Total Medical Medicare Standardized Payment Amount | 408844.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 949 |
| Number Of Beneficiaries Age 65 to 74 | 2380 |
| Number Of Beneficiaries Age 75 to 84 | 2135 |
| Number Of Beneficiaries Age Greater 84 | 1245 |
| Number Of Female Beneficiaries | 4144 |
| Number Of Male Beneficiaries | 2565 |
| Number Of Non Hispanic White Beneficiaries | 5864 |
| Number Of Black or African American Beneficiaries | 383 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 259 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 138 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5110 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1599 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6031 |