| National Provider Identifier [NPI]: | 1174501076 |
| Last Name Of The Provider | REPISHTI |
| First Name Of The Provider | DAREN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5129 DIXIE HWY |
| Street Address 2 Of The Provider | STE. 100 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402161727 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 235 |
| Number Of Services | 4954 |
| Number Of Medicare Beneficiaries | 1981 |
| Total Submitted Charge Amount | 882678 |
| Total Medicare Allowed Amount | 207504.82 |
| Total Medicare Payment Amount | 158039.14 |
| Total Medicare Standardized Payment Amount | 169063.75 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 513 |
| Number Of Beneficiaries Age 65 to 74 | 693 |
| Number Of Beneficiaries Age 75 to 84 | 549 |
| Number Of Beneficiaries Age Greater 84 | 226 |
| Number Of Female Beneficiaries | 1214 |
| Number Of Male Beneficiaries | 767 |
| Number Of Non Hispanic White Beneficiaries | 1707 |
| Number Of Black or African American Beneficiaries | 235 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1427 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 554 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.15 |