| National Provider Identifier [NPI]: | 1871608190 |
| Last Name Of The Provider | RAO |
| First Name Of The Provider | KISHORE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 COLISEUM DR |
| Street Address 2 Of The Provider | SENTARA CAREPLEX HOSPITAL |
| City Of The Provider | HAMPTON |
| Zip Code Of The Provider | 236665963 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 181 |
| Number Of Services | 3446 |
| Number Of Medicare Beneficiaries | 2397 |
| Total Submitted Charge Amount | 399686 |
| Total Medicare Allowed Amount | 121263.48 |
| Total Medicare Payment Amount | 87072.24 |
| Total Medicare Standardized Payment Amount | 90977.61 |
| 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 | 181 |
| Number Of Medical Services | 3446 |
| Number Of Medicare Beneficiaries With Medical Services | 2397 |
| Total Medical Submitted Charge Amount | 399686 |
| Total Medical Medicare Allowed Amount | 121263.48 |
| Total Medical Medicare Payment Amount | 87072.24 |
| Total Medical Medicare Standardized Payment Amount | 90977.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 459 |
| Number Of Beneficiaries Age 65 to 74 | 853 |
| Number Of Beneficiaries Age 75 to 84 | 726 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 1417 |
| Number Of Male Beneficiaries | 980 |
| Number Of Non Hispanic White Beneficiaries | 1318 |
| Number Of Black or African American Beneficiaries | 994 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1894 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 503 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8668 |