| National Provider Identifier [NPI]: | 1689601502 |
| Last Name Of The Provider | RETHY |
| First Name Of The Provider | MICHAEL |
| 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 | 39668 THOMAS MILL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 201756928 |
| 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 | 103 |
| Number Of Services | 2486 |
| Number Of Medicare Beneficiaries | 1741 |
| Total Submitted Charge Amount | 203291.17 |
| Total Medicare Allowed Amount | 51904.72 |
| Total Medicare Payment Amount | 40361.14 |
| Total Medicare Standardized Payment Amount | 40930.78 |
| 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 | 103 |
| Number Of Medical Services | 2486 |
| Number Of Medicare Beneficiaries With Medical Services | 1741 |
| Total Medical Submitted Charge Amount | 203291.17 |
| Total Medical Medicare Allowed Amount | 51904.72 |
| Total Medical Medicare Payment Amount | 40361.14 |
| Total Medical Medicare Standardized Payment Amount | 40930.78 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 393 |
| Number Of Beneficiaries Age 65 to 74 | 568 |
| Number Of Beneficiaries Age 75 to 84 | 491 |
| Number Of Beneficiaries Age Greater 84 | 289 |
| Number Of Female Beneficiaries | 944 |
| Number Of Male Beneficiaries | 797 |
| Number Of Non Hispanic White Beneficiaries | 1404 |
| Number Of Black or African American Beneficiaries | 128 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 127 |
| Number Of American Indian Alaska Native Beneficiaries | 57 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1107 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 634 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.223 |