| National Provider Identifier [NPI]: | 1164428363 |
| Last Name Of The Provider | ROBERTS |
| First Name Of The Provider | DAYNE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 YADKIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ALBEMARLE |
| Zip Code Of The Provider | 280013441 |
| 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 | 193 |
| Number Of Services | 6254 |
| Number Of Medicare Beneficiaries | 3294 |
| Total Submitted Charge Amount | 471927.5 |
| Total Medicare Allowed Amount | 158037.27 |
| Total Medicare Payment Amount | 123422.18 |
| Total Medicare Standardized Payment Amount | 131039.47 |
| 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 | 193 |
| Number Of Medical Services | 6254 |
| Number Of Medicare Beneficiaries With Medical Services | 3294 |
| Total Medical Submitted Charge Amount | 471927.5 |
| Total Medical Medicare Allowed Amount | 158037.27 |
| Total Medical Medicare Payment Amount | 123422.18 |
| Total Medical Medicare Standardized Payment Amount | 131039.47 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 516 |
| Number Of Beneficiaries Age 65 to 74 | 1237 |
| Number Of Beneficiaries Age 75 to 84 | 998 |
| Number Of Beneficiaries Age Greater 84 | 543 |
| Number Of Female Beneficiaries | 2191 |
| Number Of Male Beneficiaries | 1103 |
| Number Of Non Hispanic White Beneficiaries | 3104 |
| Number Of Black or African American Beneficiaries | 24 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 30 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2558 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 736 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.332 |