| National Provider Identifier [NPI]: | 1265437545 |
| Last Name Of The Provider | COLLIVER |
| First Name Of The Provider | VIRGINIA |
| 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 | 6410 ROCKLEDGE DR |
| Street Address 2 Of The Provider | STE 200 |
| City Of The Provider | BETHESDA |
| Zip Code Of The Provider | 208171830 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 2864 |
| Number Of Medicare Beneficiaries | 1227 |
| Total Submitted Charge Amount | 540815 |
| Total Medicare Allowed Amount | 228163.71 |
| Total Medicare Payment Amount | 169447.37 |
| Total Medicare Standardized Payment Amount | 151373.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 10164 |
| Total Drug Medicare AllowedAmount | 4438.02 |
| Total Drug Medicare PaymentAmount | 3479.35 |
| Total Drug Medicare Standardized Payment Amount | 3479.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2780 |
| Number Of Medicare Beneficiaries With Medical Services | 1226 |
| Total Medical Submitted Charge Amount | 530651 |
| Total Medical Medicare Allowed Amount | 223725.69 |
| Total Medical Medicare Payment Amount | 165968.02 |
| Total Medical Medicare Standardized Payment Amount | 147894.58 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 498 |
| Number Of Beneficiaries Age Greater 84 | 338 |
| Number Of Female Beneficiaries | 730 |
| Number Of Male Beneficiaries | 497 |
| Number Of Non Hispanic White Beneficiaries | 1029 |
| Number Of Black or African American Beneficiaries | 77 |
| Number Of AsianPacific Islander Beneficiaries | 65 |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 118 |
| Percent Of With Atrial Fibrillation | 36 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.3987 |