| National Provider Identifier [NPI]: | 1659361269 |
| Last Name Of The Provider | DEWAN |
| First Name Of The Provider | DEVAKI |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1106 DRUID RD S |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563846 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 175 |
| Number Of Services | 11891 |
| Number Of Medicare Beneficiaries | 3931 |
| Total Submitted Charge Amount | 1042244 |
| Total Medicare Allowed Amount | 233492.1 |
| Total Medicare Payment Amount | 182960.84 |
| Total Medicare Standardized Payment Amount | 184675.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 5986 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 16425 |
| Total Drug Medicare AllowedAmount | 1657.51 |
| Total Drug Medicare PaymentAmount | 1272.34 |
| Total Drug Medicare Standardized Payment Amount | 1272.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 172 |
| Number Of Medical Services | 5905 |
| Number Of Medicare Beneficiaries With Medical Services | 3930 |
| Total Medical Submitted Charge Amount | 1025819 |
| Total Medical Medicare Allowed Amount | 231834.59 |
| Total Medical Medicare Payment Amount | 181688.5 |
| Total Medical Medicare Standardized Payment Amount | 183402.85 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 444 |
| Number Of Beneficiaries Age 65 to 74 | 1250 |
| Number Of Beneficiaries Age 75 to 84 | 1265 |
| Number Of Beneficiaries Age Greater 84 | 972 |
| Number Of Female Beneficiaries | 2424 |
| Number Of Male Beneficiaries | 1507 |
| Number Of Non Hispanic White Beneficiaries | 3646 |
| Number Of Black or African American Beneficiaries | 87 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 759 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 18 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.8722 |