| National Provider Identifier [NPI]: | 1851598239 |
| Last Name Of The Provider | COCKRELL |
| First Name Of The Provider | CHARLOTTE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1508 WILLOW LAWN DR |
| Street Address 2 Of The Provider | STE 117 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232303421 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 12137 |
| Number Of Medicare Beneficiaries | 2456 |
| Total Submitted Charge Amount | 647712.1 |
| Total Medicare Allowed Amount | 239537.81 |
| Total Medicare Payment Amount | 192168.5 |
| Total Medicare Standardized Payment Amount | 197581.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 8302 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 6541.1 |
| Total Drug Medicare AllowedAmount | 2798.12 |
| Total Drug Medicare PaymentAmount | 2193.58 |
| Total Drug Medicare Standardized Payment Amount | 2193.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 3835 |
| Number Of Medicare Beneficiaries With Medical Services | 2456 |
| Total Medical Submitted Charge Amount | 641171 |
| Total Medical Medicare Allowed Amount | 236739.69 |
| Total Medical Medicare Payment Amount | 189974.92 |
| Total Medical Medicare Standardized Payment Amount | 195387.87 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 178 |
| Number Of Beneficiaries Age 65 to 74 | 1228 |
| Number Of Beneficiaries Age 75 to 84 | 745 |
| Number Of Beneficiaries Age Greater 84 | 305 |
| Number Of Female Beneficiaries | 1686 |
| Number Of Male Beneficiaries | 770 |
| Number Of Non Hispanic White Beneficiaries | 2010 |
| Number Of Black or African American Beneficiaries | 342 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2293 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 163 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0434 |