| National Provider Identifier [NPI]: | 1104893528 |
| Last Name Of The Provider | LONG |
| First Name Of The Provider | LEANA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 KINGS WAY |
| Street Address 2 Of The Provider | SUITE 1300 |
| City Of The Provider | WILLIAMSBURG |
| Zip Code Of The Provider | 231852505 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 2225 |
| Number Of Medicare Beneficiaries | 938 |
| Total Submitted Charge Amount | 339696 |
| Total Medicare Allowed Amount | 204560.47 |
| Total Medicare Payment Amount | 140676.88 |
| Total Medicare Standardized Payment Amount | 144360.91 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 518 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 92 |
| Number Of Female Beneficiaries | 577 |
| Number Of Male Beneficiaries | 361 |
| Number Of Non Hispanic White Beneficiaries | 826 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 909 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8867 |