| National Provider Identifier [NPI]: | 1457309874 |
| Last Name Of The Provider | RAY |
| First Name Of The Provider | BISWAMAY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1812 BROADWAY ST |
| Street Address 2 Of The Provider | SUITE 23 |
| City Of The Provider | MELROSE PARK |
| Zip Code Of The Provider | 601602039 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 895 |
| Number Of Medicare Beneficiaries | 91 |
| Total Submitted Charge Amount | 226395 |
| Total Medicare Allowed Amount | 85694.1 |
| Total Medicare Payment Amount | 66666.23 |
| Total Medicare Standardized Payment Amount | 63807.92 |
| 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 | 22 |
| Number Of Medical Services | 895 |
| Number Of Medicare Beneficiaries With Medical Services | 91 |
| Total Medical Submitted Charge Amount | 226395 |
| Total Medical Medicare Allowed Amount | 85694.1 |
| Total Medical Medicare Payment Amount | 66666.23 |
| Total Medical Medicare Standardized Payment Amount | 63807.92 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 31 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 13 |
| Number Of Male Beneficiaries | 78 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 75 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 18 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 29 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 24 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.0711 |