| National Provider Identifier [NPI]: | 1710917869 |
| Last Name Of The Provider | RAO |
| First Name Of The Provider | CHETHANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3620 JOSEPH SIEWICK DR |
| Street Address 2 Of The Provider | SUITE 303 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220331756 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 952 |
| Number Of Medicare Beneficiaries | 156 |
| Total Submitted Charge Amount | 132865 |
| Total Medicare Allowed Amount | 68947.45 |
| Total Medicare Payment Amount | 51727.36 |
| Total Medicare Standardized Payment Amount | 47947.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 5488 |
| Total Drug Medicare AllowedAmount | 2427.36 |
| Total Drug Medicare PaymentAmount | 2345.98 |
| Total Drug Medicare Standardized Payment Amount | 2345.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 885 |
| Number Of Medicare Beneficiaries With Medical Services | 156 |
| Total Medical Submitted Charge Amount | 127377 |
| Total Medical Medicare Allowed Amount | 66520.09 |
| Total Medical Medicare Payment Amount | 49381.38 |
| Total Medical Medicare Standardized Payment Amount | 45601.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 90 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 110 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | 84 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 139 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9484 |