| National Provider Identifier [NPI]: | 1497780340 |
| Last Name Of The Provider | RAINES |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1850 BEAM AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MAPLEWOOD |
| Zip Code Of The Provider | 551091162 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 1843 |
| Number Of Medicare Beneficiaries | 262 |
| Total Submitted Charge Amount | 154137 |
| Total Medicare Allowed Amount | 65966.74 |
| Total Medicare Payment Amount | 49532.46 |
| Total Medicare Standardized Payment Amount | 50533.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 104 |
| Number Of Medicare Beneficiaries With Drug Services | 80 |
| Total Drug Submitted ChargeAmount | 4928 |
| Total Drug Medicare AllowedAmount | 2391.46 |
| Total Drug Medicare PaymentAmount | 2230.55 |
| Total Drug Medicare Standardized Payment Amount | 2230.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1739 |
| Number Of Medicare Beneficiaries With Medical Services | 262 |
| Total Medical Submitted Charge Amount | 149209 |
| Total Medical Medicare Allowed Amount | 63575.28 |
| Total Medical Medicare Payment Amount | 47301.91 |
| Total Medical Medicare Standardized Payment Amount | 48302.51 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 89 |
| Number Of Beneficiaries Age 65 to 74 | 78 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 122 |
| Number Of Non Hispanic White Beneficiaries | 237 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 82 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1087 |