| National Provider Identifier [NPI]: | 1962575605 |
| Last Name Of The Provider | MARTIROSIAN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7603 FOREST AVENUE |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 23229 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 5971 |
| Number Of Medicare Beneficiaries | 1158 |
| Total Submitted Charge Amount | 659027 |
| Total Medicare Allowed Amount | 396619.07 |
| Total Medicare Payment Amount | 284476.45 |
| Total Medicare Standardized Payment Amount | 271360.91 |
| 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 | 20 |
| Number Of Medical Services | 5971 |
| Number Of Medicare Beneficiaries With Medical Services | 1158 |
| Total Medical Submitted Charge Amount | 659027 |
| Total Medical Medicare Allowed Amount | 396619.07 |
| Total Medical Medicare Payment Amount | 284476.45 |
| Total Medical Medicare Standardized Payment Amount | 271360.91 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 393 |
| Number Of Beneficiaries Age 75 to 84 | 422 |
| Number Of Beneficiaries Age Greater 84 | 301 |
| Number Of Female Beneficiaries | 645 |
| Number Of Male Beneficiaries | 513 |
| Number Of Non Hispanic White Beneficiaries | 1000 |
| Number Of Black or African American Beneficiaries | 135 |
| 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 | 1099 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.2798 |