| National Provider Identifier [NPI]: | 1457434524 |
| Last Name Of The Provider | RAWSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3264 N EVERGREEN DR NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND RAPIDS |
| Zip Code Of The Provider | 495259746 |
| 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 | 190 |
| Number Of Services | 6084 |
| Number Of Medicare Beneficiaries | 3123 |
| Total Submitted Charge Amount | 643084 |
| Total Medicare Allowed Amount | 173844.4 |
| Total Medicare Payment Amount | 137434.19 |
| Total Medicare Standardized Payment Amount | 141464.48 |
| 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 | 190 |
| Number Of Medical Services | 6084 |
| Number Of Medicare Beneficiaries With Medical Services | 3123 |
| Total Medical Submitted Charge Amount | 643084 |
| Total Medical Medicare Allowed Amount | 173844.4 |
| Total Medical Medicare Payment Amount | 137434.19 |
| Total Medical Medicare Standardized Payment Amount | 141464.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 652 |
| Number Of Beneficiaries Age 65 to 74 | 1257 |
| Number Of Beneficiaries Age 75 to 84 | 831 |
| Number Of Beneficiaries Age Greater 84 | 383 |
| Number Of Female Beneficiaries | 2127 |
| Number Of Male Beneficiaries | 996 |
| Number Of Non Hispanic White Beneficiaries | 2809 |
| Number Of Black or African American Beneficiaries | 193 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2394 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 729 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3983 |