| National Provider Identifier [NPI]: | 1386602787 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 E WOOD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPARTANBURG |
| Zip Code Of The Provider | 293033040 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 7860 |
| Number Of Medicare Beneficiaries | 4469 |
| Total Submitted Charge Amount | 834540 |
| Total Medicare Allowed Amount | 183451.85 |
| Total Medicare Payment Amount | 153276.61 |
| Total Medicare Standardized Payment Amount | 162187.32 |
| 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 | 164 |
| Number Of Medical Services | 7860 |
| Number Of Medicare Beneficiaries With Medical Services | 4469 |
| Total Medical Submitted Charge Amount | 834540 |
| Total Medical Medicare Allowed Amount | 183451.85 |
| Total Medical Medicare Payment Amount | 153276.61 |
| Total Medical Medicare Standardized Payment Amount | 162187.32 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 846 |
| Number Of Beneficiaries Age 65 to 74 | 1988 |
| Number Of Beneficiaries Age 75 to 84 | 1242 |
| Number Of Beneficiaries Age Greater 84 | 393 |
| Number Of Female Beneficiaries | 3390 |
| Number Of Male Beneficiaries | 1079 |
| Number Of Non Hispanic White Beneficiaries | 3752 |
| Number Of Black or African American Beneficiaries | 644 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 934 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4317 |