| National Provider Identifier [NPI]: | 1134140981 |
| Last Name Of The Provider | JAIN |
| First Name Of The Provider | RAVI |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28 CRESCENT ST |
| Street Address 2 Of The Provider | MIDDLESEX HOSPITAL |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 064573654 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 177 |
| Number Of Services | 7093 |
| Number Of Medicare Beneficiaries | 4054 |
| Total Submitted Charge Amount | 735619.5 |
| Total Medicare Allowed Amount | 223316.88 |
| Total Medicare Payment Amount | 171746.7 |
| Total Medicare Standardized Payment Amount | 163630.02 |
| 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 | 177 |
| Number Of Medical Services | 7093 |
| Number Of Medicare Beneficiaries With Medical Services | 4054 |
| Total Medical Submitted Charge Amount | 735619.5 |
| Total Medical Medicare Allowed Amount | 223316.88 |
| Total Medical Medicare Payment Amount | 171746.7 |
| Total Medical Medicare Standardized Payment Amount | 163630.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 586 |
| Number Of Beneficiaries Age 65 to 74 | 1341 |
| Number Of Beneficiaries Age 75 to 84 | 1260 |
| Number Of Beneficiaries Age Greater 84 | 867 |
| Number Of Female Beneficiaries | 2654 |
| Number Of Male Beneficiaries | 1400 |
| Number Of Non Hispanic White Beneficiaries | 3690 |
| Number Of Black or African American Beneficiaries | 172 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 93 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 64 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2838 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1216 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4371 |