| National Provider Identifier [NPI]: | 1427091586 |
| Last Name Of The Provider | RAKER |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1111 E MCDOWELL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850062612 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 132 |
| Number Of Services | 1136 |
| Number Of Medicare Beneficiaries | 472 |
| Total Submitted Charge Amount | 229744 |
| Total Medicare Allowed Amount | 109632.11 |
| Total Medicare Payment Amount | 85098.24 |
| Total Medicare Standardized Payment Amount | 80932.66 |
| 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 | 132 |
| Number Of Medical Services | 1136 |
| Number Of Medicare Beneficiaries With Medical Services | 472 |
| Total Medical Submitted Charge Amount | 229744 |
| Total Medical Medicare Allowed Amount | 109632.11 |
| Total Medical Medicare Payment Amount | 85098.24 |
| Total Medical Medicare Standardized Payment Amount | 80932.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 109 |
| Number Of Beneficiaries Age 65 to 74 | 135 |
| Number Of Beneficiaries Age 75 to 84 | 142 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 254 |
| Number Of Male Beneficiaries | 218 |
| Number Of Non Hispanic White Beneficiaries | 227 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 86 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 247 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 59 |
| Percent Of With Chronic Kidney Disease | 63 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 3.3963 |