| National Provider Identifier [NPI]: | 1649372566 |
| Last Name Of The Provider | RAY |
| First Name Of The Provider | DIPES |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D., MRCP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 213 RIVER WALK PKWY |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | CHESAPEAKE |
| Zip Code Of The Provider | 233206893 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1193 |
| Number Of Medicare Beneficiaries | 334 |
| Total Submitted Charge Amount | 121168 |
| Total Medicare Allowed Amount | 75629.37 |
| Total Medicare Payment Amount | 53393.05 |
| Total Medicare Standardized Payment Amount | 56206.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 68 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 1226 |
| Total Drug Medicare AllowedAmount | 930.9 |
| Total Drug Medicare PaymentAmount | 904.99 |
| Total Drug Medicare Standardized Payment Amount | 904.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 1125 |
| Number Of Medicare Beneficiaries With Medical Services | 334 |
| Total Medical Submitted Charge Amount | 119942 |
| Total Medical Medicare Allowed Amount | 74698.47 |
| Total Medical Medicare Payment Amount | 52488.06 |
| Total Medical Medicare Standardized Payment Amount | 55301.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 96 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 155 |
| Number Of Male Beneficiaries | 179 |
| Number Of Non Hispanic White Beneficiaries | 215 |
| Number Of Black or African American Beneficiaries | 103 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1851 |