| National Provider Identifier [NPI]: | 1700848454 |
| Last Name Of The Provider | EDWARDS |
| First Name Of The Provider | VANCE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 MEDICAL OFFICE PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOLDSBORO |
| Zip Code Of The Provider | 275349460 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 192 |
| Number Of Services | 14984 |
| Number Of Medicare Beneficiaries | 4132 |
| Total Submitted Charge Amount | 1898824 |
| Total Medicare Allowed Amount | 411087.87 |
| Total Medicare Payment Amount | 324780.24 |
| Total Medicare Standardized Payment Amount | 345660.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7450 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 1785 |
| Total Drug Medicare AllowedAmount | 1731 |
| Total Drug Medicare PaymentAmount | 1357.12 |
| Total Drug Medicare Standardized Payment Amount | 1357.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 190 |
| Number Of Medical Services | 7534 |
| Number Of Medicare Beneficiaries With Medical Services | 4132 |
| Total Medical Submitted Charge Amount | 1897039 |
| Total Medical Medicare Allowed Amount | 409356.87 |
| Total Medical Medicare Payment Amount | 323423.12 |
| Total Medical Medicare Standardized Payment Amount | 344302.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1012 |
| Number Of Beneficiaries Age 65 to 74 | 1539 |
| Number Of Beneficiaries Age 75 to 84 | 1120 |
| Number Of Beneficiaries Age Greater 84 | 461 |
| Number Of Female Beneficiaries | 2711 |
| Number Of Male Beneficiaries | 1421 |
| Number Of Non Hispanic White Beneficiaries | 2812 |
| Number Of Black or African American Beneficiaries | 1218 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2755 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1377 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4873 |