| National Provider Identifier [NPI]: | 1619964087 |
| Last Name Of The Provider | FRAVEL |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 S UNIVERSITY AVE |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722055302 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 199 |
| Number Of Services | 11106 |
| Number Of Medicare Beneficiaries | 4660 |
| Total Submitted Charge Amount | 942095 |
| Total Medicare Allowed Amount | 330640.99 |
| Total Medicare Payment Amount | 260895.12 |
| Total Medicare Standardized Payment Amount | 291276.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2844 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 1986 |
| Total Drug Medicare AllowedAmount | 762.92 |
| Total Drug Medicare PaymentAmount | 598.14 |
| Total Drug Medicare Standardized Payment Amount | 598.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 195 |
| Number Of Medical Services | 8262 |
| Number Of Medicare Beneficiaries With Medical Services | 4660 |
| Total Medical Submitted Charge Amount | 940109 |
| Total Medical Medicare Allowed Amount | 329878.07 |
| Total Medical Medicare Payment Amount | 260296.98 |
| Total Medical Medicare Standardized Payment Amount | 290678.6 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 916 |
| Number Of Beneficiaries Age 65 to 74 | 1795 |
| Number Of Beneficiaries Age 75 to 84 | 1350 |
| Number Of Beneficiaries Age Greater 84 | 599 |
| Number Of Female Beneficiaries | 3335 |
| Number Of Male Beneficiaries | 1325 |
| Number Of Non Hispanic White Beneficiaries | 3933 |
| Number Of Black or African American Beneficiaries | 640 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3513 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1147 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.3552 |