| National Provider Identifier [NPI]: | 1689765059 |
| Last Name Of The Provider | LOMIS |
| First Name Of The Provider | VAN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9106 PHILADELPHIA RD |
| Street Address 2 Of The Provider | SUITE 308 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212374329 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 2163 |
| Number Of Medicare Beneficiaries | 430 |
| Total Submitted Charge Amount | 172253.83 |
| Total Medicare Allowed Amount | 167808.36 |
| Total Medicare Payment Amount | 118163.07 |
| Total Medicare Standardized Payment Amount | 113121.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 396 |
| Number Of Medicare Beneficiaries With Drug Services | 288 |
| Total Drug Submitted ChargeAmount | 9408.05 |
| Total Drug Medicare AllowedAmount | 9273.87 |
| Total Drug Medicare PaymentAmount | 9071.36 |
| Total Drug Medicare Standardized Payment Amount | 9071.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1767 |
| Number Of Medicare Beneficiaries With Medical Services | 430 |
| Total Medical Submitted Charge Amount | 162845.78 |
| Total Medical Medicare Allowed Amount | 158534.49 |
| Total Medical Medicare Payment Amount | 109091.71 |
| Total Medical Medicare Standardized Payment Amount | 104050.21 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 148 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 220 |
| Number Of Male Beneficiaries | 210 |
| Number Of Non Hispanic White Beneficiaries | 405 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 413 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8994 |