| National Provider Identifier [NPI]: | 1912218280 |
| Last Name Of The Provider | RAQUEPAU |
| First Name Of The Provider | AMY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 263 FARMINGTON AVE |
| Street Address 2 Of The Provider | ORTHOPAEDICS |
| City Of The Provider | FARMINGTON |
| Zip Code Of The Provider | 060300001 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 448 |
| Number Of Medicare Beneficiaries | 216 |
| Total Submitted Charge Amount | 45405.89 |
| Total Medicare Allowed Amount | 29654.77 |
| Total Medicare Payment Amount | 21038.05 |
| Total Medicare Standardized Payment Amount | 21954.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 142.19 |
| Total Drug Medicare AllowedAmount | 67.33 |
| Total Drug Medicare PaymentAmount | 52.77 |
| Total Drug Medicare Standardized Payment Amount | 52.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 422 |
| Number Of Medicare Beneficiaries With Medical Services | 216 |
| Total Medical Submitted Charge Amount | 45263.7 |
| Total Medical Medicare Allowed Amount | 29587.44 |
| Total Medical Medicare Payment Amount | 20985.28 |
| Total Medical Medicare Standardized Payment Amount | 21901.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 105 |
| Number Of Beneficiaries Age 75 to 84 | 58 |
| Number Of Beneficiaries Age Greater 84 | 31 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 178 |
| Number Of Black or African American Beneficiaries | 21 |
| 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 | 196 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9505 |