| National Provider Identifier [NPI]: | 1205097441 |
| Last Name Of The Provider | SOMERVILLE |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| 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 | 153 |
| Number Of Services | 2666 |
| Number Of Medicare Beneficiaries | 1962 |
| Total Submitted Charge Amount | 276555 |
| Total Medicare Allowed Amount | 97732.49 |
| Total Medicare Payment Amount | 75233.76 |
| Total Medicare Standardized Payment Amount | 78108.17 |
| 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 | 153 |
| Number Of Medical Services | 2666 |
| Number Of Medicare Beneficiaries With Medical Services | 1962 |
| Total Medical Submitted Charge Amount | 276555 |
| Total Medical Medicare Allowed Amount | 97732.49 |
| Total Medical Medicare Payment Amount | 75233.76 |
| Total Medical Medicare Standardized Payment Amount | 78108.17 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 359 |
| Number Of Beneficiaries Age 65 to 74 | 742 |
| Number Of Beneficiaries Age 75 to 84 | 535 |
| Number Of Beneficiaries Age Greater 84 | 326 |
| Number Of Female Beneficiaries | 1152 |
| Number Of Male Beneficiaries | 810 |
| Number Of Non Hispanic White Beneficiaries | 1493 |
| Number Of Black or African American Beneficiaries | 410 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1584 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 378 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8768 |