| National Provider Identifier [NPI]: | 1215159447 |
| Last Name Of The Provider | ELLIOTT |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | Z |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 J CLYDE MORRIS BLVD |
| Street Address 2 Of The Provider | RIVERSIDE REGIONAL MEDICAL CENTER |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 236011929 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 184 |
| Number Of Services | 7134 |
| Number Of Medicare Beneficiaries | 4914 |
| Total Submitted Charge Amount | 796373 |
| Total Medicare Allowed Amount | 222407.22 |
| Total Medicare Payment Amount | 164801.54 |
| Total Medicare Standardized Payment Amount | 171239.6 |
| 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 | 184 |
| Number Of Medical Services | 7134 |
| Number Of Medicare Beneficiaries With Medical Services | 4914 |
| Total Medical Submitted Charge Amount | 796373 |
| Total Medical Medicare Allowed Amount | 222407.22 |
| Total Medical Medicare Payment Amount | 164801.54 |
| Total Medical Medicare Standardized Payment Amount | 171239.6 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 670 |
| Number Of Beneficiaries Age 65 to 74 | 1930 |
| Number Of Beneficiaries Age 75 to 84 | 1503 |
| Number Of Beneficiaries Age Greater 84 | 811 |
| Number Of Female Beneficiaries | 3021 |
| Number Of Male Beneficiaries | 1893 |
| Number Of Non Hispanic White Beneficiaries | 3754 |
| Number Of Black or African American Beneficiaries | 1008 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 55 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 790 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5904 |