| National Provider Identifier [NPI]: | 1275768491 |
| Last Name Of The Provider | HINES |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | U |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1705 EAST BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTE |
| Zip Code Of The Provider | 282035800 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 291 |
| Number Of Services | 4006 |
| Number Of Medicare Beneficiaries | 1900 |
| Total Submitted Charge Amount | 885681.98 |
| Total Medicare Allowed Amount | 219749.52 |
| Total Medicare Payment Amount | 169677.93 |
| Total Medicare Standardized Payment Amount | 163724.97 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 345 |
| Number Of Beneficiaries Age 65 to 74 | 641 |
| Number Of Beneficiaries Age 75 to 84 | 546 |
| Number Of Beneficiaries Age Greater 84 | 368 |
| Number Of Female Beneficiaries | 1103 |
| Number Of Male Beneficiaries | 797 |
| Number Of Non Hispanic White Beneficiaries | 1347 |
| Number Of Black or African American Beneficiaries | 390 |
| Number Of AsianPacific Islander Beneficiaries | 67 |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1426 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 474 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0029 |