| National Provider Identifier [NPI]: | 1295729689 |
| Last Name Of The Provider | DORVAULT |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2055 NORMANDIE DR |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | MONTGOMERY |
| Zip Code Of The Provider | 361112732 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 261 |
| Number Of Services | 34730 |
| Number Of Medicare Beneficiaries | 9795 |
| Total Submitted Charge Amount | 1888439.72 |
| Total Medicare Allowed Amount | 740860.68 |
| Total Medicare Payment Amount | 559620.02 |
| Total Medicare Standardized Payment Amount | 573491.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 16016 |
| Number Of Medicare Beneficiaries With Drug Services | 214 |
| Total Drug Submitted ChargeAmount | 19891 |
| Total Drug Medicare AllowedAmount | 5301.23 |
| Total Drug Medicare PaymentAmount | 4025.12 |
| Total Drug Medicare Standardized Payment Amount | 4025.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 258 |
| Number Of Medical Services | 18714 |
| Number Of Medicare Beneficiaries With Medical Services | 9795 |
| Total Medical Submitted Charge Amount | 1868548.72 |
| Total Medical Medicare Allowed Amount | 735559.45 |
| Total Medical Medicare Payment Amount | 555594.9 |
| Total Medical Medicare Standardized Payment Amount | 569466.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1706 |
| Number Of Beneficiaries Age 65 to 74 | 3827 |
| Number Of Beneficiaries Age 75 to 84 | 2970 |
| Number Of Beneficiaries Age Greater 84 | 1292 |
| Number Of Female Beneficiaries | 6154 |
| Number Of Male Beneficiaries | 3641 |
| Number Of Non Hispanic White Beneficiaries | 8417 |
| Number Of Black or African American Beneficiaries | 1049 |
| Number Of AsianPacific Islander Beneficiaries | 80 |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | 49 |
| Number Of Beneficiaries With Race Not Else where Classified | 71 |
| Number Of Beneficiaries With Medicare Only Entitlement | 7867 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1928 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.474 |