| National Provider Identifier [NPI]: | 1831315266 |
| Last Name Of The Provider | VERVILLE |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 975 E 3RD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374032103 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 185 |
| Number Of Services | 11288 |
| Number Of Medicare Beneficiaries | 2528 |
| Total Submitted Charge Amount | 1013760.96 |
| Total Medicare Allowed Amount | 214035.28 |
| Total Medicare Payment Amount | 167619.92 |
| Total Medicare Standardized Payment Amount | 183895.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 7313 |
| Number Of Medicare Beneficiaries With Drug Services | 105 |
| Total Drug Submitted ChargeAmount | 9345.68 |
| Total Drug Medicare AllowedAmount | 2786.46 |
| Total Drug Medicare PaymentAmount | 2136.71 |
| Total Drug Medicare Standardized Payment Amount | 2136.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 3975 |
| Number Of Medicare Beneficiaries With Medical Services | 2527 |
| Total Medical Submitted Charge Amount | 1004415.28 |
| Total Medical Medicare Allowed Amount | 211248.82 |
| Total Medical Medicare Payment Amount | 165483.21 |
| Total Medical Medicare Standardized Payment Amount | 181759.15 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 617 |
| Number Of Beneficiaries Age 65 to 74 | 995 |
| Number Of Beneficiaries Age 75 to 84 | 658 |
| Number Of Beneficiaries Age Greater 84 | 258 |
| Number Of Female Beneficiaries | 1684 |
| Number Of Male Beneficiaries | 844 |
| Number Of Non Hispanic White Beneficiaries | 2230 |
| Number Of Black or African American Beneficiaries | 246 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1749 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 779 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5274 |