| National Provider Identifier [NPI]: | 1770513137 |
| Last Name Of The Provider | RUDRARAJU |
| First Name Of The Provider | VENKAT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4491 VENOY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WAYNE |
| Zip Code Of The Provider | 481842530 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 246 |
| Number Of Services | 20516 |
| Number Of Medicare Beneficiaries | 3447 |
| Total Submitted Charge Amount | 740969.5 |
| Total Medicare Allowed Amount | 294495.75 |
| Total Medicare Payment Amount | 225232.84 |
| Total Medicare Standardized Payment Amount | 219225.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 14685 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 16522.5 |
| Total Drug Medicare AllowedAmount | 2862.61 |
| Total Drug Medicare PaymentAmount | 2243.98 |
| Total Drug Medicare Standardized Payment Amount | 2243.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 244 |
| Number Of Medical Services | 5831 |
| Number Of Medicare Beneficiaries With Medical Services | 3447 |
| Total Medical Submitted Charge Amount | 724447 |
| Total Medical Medicare Allowed Amount | 291633.14 |
| Total Medical Medicare Payment Amount | 222988.86 |
| Total Medical Medicare Standardized Payment Amount | 216981.53 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 933 |
| Number Of Beneficiaries Age 65 to 74 | 1042 |
| Number Of Beneficiaries Age 75 to 84 | 842 |
| Number Of Beneficiaries Age Greater 84 | 630 |
| Number Of Female Beneficiaries | 2020 |
| Number Of Male Beneficiaries | 1427 |
| Number Of Non Hispanic White Beneficiaries | 2497 |
| Number Of Black or African American Beneficiaries | 720 |
| Number Of AsianPacific Islander Beneficiaries | 67 |
| Number Of Hispanic Beneficiaries | 109 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 54 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2188 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1259 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 51 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3188 |