| National Provider Identifier [NPI]: | 1053336669 |
| Last Name Of The Provider | AMODEI |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3015 WILLIAMS DR STE 200 |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314623 |
| 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 | 42 |
| Number Of Services | 1454 |
| Number Of Medicare Beneficiaries | 596 |
| Total Submitted Charge Amount | 288542 |
| Total Medicare Allowed Amount | 129592.2 |
| Total Medicare Payment Amount | 104510.13 |
| Total Medicare Standardized Payment Amount | 92698.16 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 270 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 2160 |
| Total Drug Medicare AllowedAmount | 536.73 |
| Total Drug Medicare PaymentAmount | 402.48 |
| Total Drug Medicare Standardized Payment Amount | 402.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1184 |
| Number Of Medicare Beneficiaries With Medical Services | 596 |
| Total Medical Submitted Charge Amount | 286382 |
| Total Medical Medicare Allowed Amount | 129055.47 |
| Total Medical Medicare Payment Amount | 104107.65 |
| Total Medical Medicare Standardized Payment Amount | 92295.68 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 409 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 575 |
| Number Of Male Beneficiaries | 21 |
| Number Of Non Hispanic White Beneficiaries | 442 |
| Number Of Black or African American Beneficiaries | 90 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 579 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 2 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 6 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 4 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 11 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6438 |