| National Provider Identifier [NPI]: | 1548370612 |
| Last Name Of The Provider | WADLOW |
| First Name Of The Provider | RAYMOND |
| 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 | 8503 ARLINGTON BLVD |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314629 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Medical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 83169 |
| Number Of Medicare Beneficiaries | 1698 |
| Total Submitted Charge Amount | 4694068 |
| Total Medicare Allowed Amount | 1344517.29 |
| Total Medicare Payment Amount | 1046875.8 |
| Total Medicare Standardized Payment Amount | 1015056.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 75 |
| Number Of Drug Services | 73617 |
| Number Of Medicare Beneficiaries With Drug Services | 269 |
| Total Drug Submitted ChargeAmount | 3550791 |
| Total Drug Medicare AllowedAmount | 954233.77 |
| Total Drug Medicare PaymentAmount | 734059.12 |
| Total Drug Medicare Standardized Payment Amount | 734059.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 9552 |
| Number Of Medicare Beneficiaries With Medical Services | 1698 |
| Total Medical Submitted Charge Amount | 1143277 |
| Total Medical Medicare Allowed Amount | 390283.52 |
| Total Medical Medicare Payment Amount | 312816.68 |
| Total Medical Medicare Standardized Payment Amount | 280996.99 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 103 |
| Number Of Beneficiaries Age 65 to 74 | 794 |
| Number Of Beneficiaries Age 75 to 84 | 565 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 896 |
| Number Of Male Beneficiaries | 802 |
| Number Of Non Hispanic White Beneficiaries | 1331 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | 110 |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 44 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.8417 |