| National Provider Identifier [NPI]: | 1477502508 |
| Last Name Of The Provider | PERUSSE |
| First Name Of The Provider | KEVIN |
| 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 | 1001 SAM PERRY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224014453 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 7917 |
| Number Of Medicare Beneficiaries | 3201 |
| Total Submitted Charge Amount | 1046122 |
| Total Medicare Allowed Amount | 216303.23 |
| Total Medicare Payment Amount | 157551.71 |
| Total Medicare Standardized Payment Amount | 164614.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3508 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 7645 |
| Total Drug Medicare AllowedAmount | 673.75 |
| Total Drug Medicare PaymentAmount | 486.08 |
| Total Drug Medicare Standardized Payment Amount | 486.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 121 |
| Number Of Medical Services | 4409 |
| Number Of Medicare Beneficiaries With Medical Services | 3201 |
| Total Medical Submitted Charge Amount | 1038477 |
| Total Medical Medicare Allowed Amount | 215629.48 |
| Total Medical Medicare Payment Amount | 157065.63 |
| Total Medical Medicare Standardized Payment Amount | 164128.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 517 |
| Number Of Beneficiaries Age 65 to 74 | 1248 |
| Number Of Beneficiaries Age 75 to 84 | 963 |
| Number Of Beneficiaries Age Greater 84 | 473 |
| Number Of Female Beneficiaries | 1895 |
| Number Of Male Beneficiaries | 1306 |
| Number Of Non Hispanic White Beneficiaries | 2568 |
| Number Of Black or African American Beneficiaries | 493 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 72 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2654 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 547 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6432 |