| National Provider Identifier [NPI]: | 1043222334 |
| Last Name Of The Provider | RAQUE |
| First Name Of The Provider | JAMES |
| 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 | 149 NORTH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | WATERVILLE |
| Zip Code Of The Provider | 049014974 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 267 |
| Number Of Services | 6203 |
| Number Of Medicare Beneficiaries | 3627 |
| Total Submitted Charge Amount | 856104 |
| Total Medicare Allowed Amount | 194013.27 |
| Total Medicare Payment Amount | 146140.27 |
| Total Medicare Standardized Payment Amount | 153979.63 |
| 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 | 267 |
| Number Of Medical Services | 6203 |
| Number Of Medicare Beneficiaries With Medical Services | 3627 |
| Total Medical Submitted Charge Amount | 856104 |
| Total Medical Medicare Allowed Amount | 194013.27 |
| Total Medical Medicare Payment Amount | 146140.27 |
| Total Medical Medicare Standardized Payment Amount | 153979.63 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 990 |
| Number Of Beneficiaries Age 65 to 74 | 1135 |
| Number Of Beneficiaries Age 75 to 84 | 942 |
| Number Of Beneficiaries Age Greater 84 | 560 |
| Number Of Female Beneficiaries | 2192 |
| Number Of Male Beneficiaries | 1435 |
| Number Of Non Hispanic White Beneficiaries | 3534 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1763 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1864 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4968 |