| National Provider Identifier [NPI]: | 1740339787 |
| Last Name Of The Provider | RAGHAVAN |
| First Name Of The Provider | PRASHANT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | UVA HOSPITAL |
| Street Address 2 Of The Provider | LEE STREET, 1ST FLOOR |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229080001 |
| 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 | 41 |
| Number Of Services | 3849 |
| Number Of Medicare Beneficiaries | 1326 |
| Total Submitted Charge Amount | 630650.24 |
| Total Medicare Allowed Amount | 153249.9 |
| Total Medicare Payment Amount | 117212 |
| Total Medicare Standardized Payment Amount | 113376.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1950 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 1815.24 |
| Total Drug Medicare AllowedAmount | 927.34 |
| Total Drug Medicare PaymentAmount | 727.08 |
| Total Drug Medicare Standardized Payment Amount | 727.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 1899 |
| Number Of Medicare Beneficiaries With Medical Services | 1326 |
| Total Medical Submitted Charge Amount | 628835 |
| Total Medical Medicare Allowed Amount | 152322.56 |
| Total Medical Medicare Payment Amount | 116484.92 |
| Total Medical Medicare Standardized Payment Amount | 112649.44 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 403 |
| Number Of Beneficiaries Age 65 to 74 | 499 |
| Number Of Beneficiaries Age 75 to 84 | 297 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 724 |
| Number Of Male Beneficiaries | 602 |
| Number Of Non Hispanic White Beneficiaries | 588 |
| Number Of Black or African American Beneficiaries | 685 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 836 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 490 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 30 |
| Average HCC Risk Score Of Beneficiaries | 2.2031 |