| National Provider Identifier [NPI]: | 1407017627 |
| Last Name Of The Provider | NORTHAM |
| First Name Of The Provider | MEREDITH |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LEE ST FL 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229080001 |
| 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 | 107 |
| Number Of Services | 3535 |
| Number Of Medicare Beneficiaries | 1778 |
| Total Submitted Charge Amount | 430726.79 |
| Total Medicare Allowed Amount | 61961.76 |
| Total Medicare Payment Amount | 45412.5 |
| Total Medicare Standardized Payment Amount | 46818.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 245 |
| Number Of Medicare Beneficiaries With Drug Services | 62 |
| Total Drug Submitted ChargeAmount | 3547.8 |
| Total Drug Medicare AllowedAmount | 563.12 |
| Total Drug Medicare PaymentAmount | 434.33 |
| Total Drug Medicare Standardized Payment Amount | 434.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 3290 |
| Number Of Medicare Beneficiaries With Medical Services | 1778 |
| Total Medical Submitted Charge Amount | 427178.99 |
| Total Medical Medicare Allowed Amount | 61398.64 |
| Total Medical Medicare Payment Amount | 44978.17 |
| Total Medical Medicare Standardized Payment Amount | 46384.33 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 526 |
| Number Of Beneficiaries Age 65 to 74 | 701 |
| Number Of Beneficiaries Age 75 to 84 | 370 |
| Number Of Beneficiaries Age Greater 84 | 181 |
| Number Of Female Beneficiaries | 1038 |
| Number Of Male Beneficiaries | 740 |
| Number Of Non Hispanic White Beneficiaries | 1342 |
| Number Of Black or African American Beneficiaries | 359 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1269 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 509 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6391 |