| National Provider Identifier [NPI]: | 1063520088 |
| Last Name Of The Provider | RANDOLPH |
| First Name Of The Provider | DONNA |
| 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 | 10529-B BRADDOCK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220322236 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1657 |
| Number Of Medicare Beneficiaries | 180 |
| Total Submitted Charge Amount | 141698 |
| Total Medicare Allowed Amount | 107587.17 |
| Total Medicare Payment Amount | 82755.66 |
| Total Medicare Standardized Payment Amount | 83958.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 194 |
| Number Of Medicare Beneficiaries With Drug Services | 122 |
| Total Drug Submitted ChargeAmount | 18050 |
| Total Drug Medicare AllowedAmount | 13537.31 |
| Total Drug Medicare PaymentAmount | 13039.26 |
| Total Drug Medicare Standardized Payment Amount | 13039.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 1463 |
| Number Of Medicare Beneficiaries With Medical Services | 180 |
| Total Medical Submitted Charge Amount | 123648 |
| Total Medical Medicare Allowed Amount | 94049.86 |
| Total Medical Medicare Payment Amount | 69716.4 |
| Total Medical Medicare Standardized Payment Amount | 70919.18 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 128 |
| Number Of Male Beneficiaries | 52 |
| Number Of Non Hispanic White Beneficiaries | 167 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8065 |