| National Provider Identifier [NPI]: | 1700804317 |
| Last Name Of The Provider | VELCHIK |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2722 MERRILEE DR |
| Street Address 2 Of The Provider | #230 |
| City Of The Provider | FAIRFAX |
| Zip Code Of The Provider | 220314400 |
| 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 | 127 |
| Number Of Services | 4491 |
| Number Of Medicare Beneficiaries | 3208 |
| Total Submitted Charge Amount | 716078.59 |
| Total Medicare Allowed Amount | 264240.08 |
| Total Medicare Payment Amount | 200093.63 |
| Total Medicare Standardized Payment Amount | 178839.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 2250 |
| Total Drug Medicare AllowedAmount | 2095.4 |
| Total Drug Medicare PaymentAmount | 1575.85 |
| Total Drug Medicare Standardized Payment Amount | 1575.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 4466 |
| Number Of Medicare Beneficiaries With Medical Services | 3207 |
| Total Medical Submitted Charge Amount | 713828.59 |
| Total Medical Medicare Allowed Amount | 262144.68 |
| Total Medical Medicare Payment Amount | 198517.78 |
| Total Medical Medicare Standardized Payment Amount | 177263.35 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 309 |
| Number Of Beneficiaries Age 65 to 74 | 1262 |
| Number Of Beneficiaries Age 75 to 84 | 1016 |
| Number Of Beneficiaries Age Greater 84 | 621 |
| Number Of Female Beneficiaries | 1769 |
| Number Of Male Beneficiaries | 1439 |
| Number Of Non Hispanic White Beneficiaries | 2320 |
| Number Of Black or African American Beneficiaries | 239 |
| Number Of AsianPacific Islander Beneficiaries | 411 |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2636 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 572 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6497 |