| National Provider Identifier [NPI]: | 1942310263 |
| Last Name Of The Provider | RAVISHANKAR |
| First Name Of The Provider | VENKATESAN |
| 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 | 1455 HARRISON AVE NW |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | CANTON |
| Zip Code Of The Provider | 447082621 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 2481 |
| Number Of Medicare Beneficiaries | 403 |
| Total Submitted Charge Amount | 253356 |
| Total Medicare Allowed Amount | 169387.63 |
| Total Medicare Payment Amount | 123984.83 |
| Total Medicare Standardized Payment Amount | 128414.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 685 |
| Total Drug Medicare AllowedAmount | 488.54 |
| Total Drug Medicare PaymentAmount | 478.01 |
| Total Drug Medicare Standardized Payment Amount | 478.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 2444 |
| Number Of Medicare Beneficiaries With Medical Services | 403 |
| Total Medical Submitted Charge Amount | 252671 |
| Total Medical Medicare Allowed Amount | 168899.09 |
| Total Medical Medicare Payment Amount | 123506.82 |
| Total Medical Medicare Standardized Payment Amount | 127936.83 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 99 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | 299 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 245 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8694 |