| National Provider Identifier [NPI]: | 1902859283 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | PAM |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 SAM PERRY BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREDERICKSBURG |
| Zip Code Of The Provider | 224014453 |
| 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 | 177 |
| Number Of Services | 9038 |
| Number Of Medicare Beneficiaries | 5191 |
| Total Submitted Charge Amount | 888008 |
| Total Medicare Allowed Amount | 331062.23 |
| Total Medicare Payment Amount | 267627.46 |
| Total Medicare Standardized Payment Amount | 257971.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 341 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 3440 |
| Total Drug Medicare AllowedAmount | 668.18 |
| Total Drug Medicare PaymentAmount | 523.86 |
| Total Drug Medicare Standardized Payment Amount | 523.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 174 |
| Number Of Medical Services | 8697 |
| Number Of Medicare Beneficiaries With Medical Services | 5191 |
| Total Medical Submitted Charge Amount | 884568 |
| Total Medical Medicare Allowed Amount | 330394.05 |
| Total Medical Medicare Payment Amount | 267103.6 |
| Total Medical Medicare Standardized Payment Amount | 257447.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 978 |
| Number Of Beneficiaries Age 65 to 74 | 2068 |
| Number Of Beneficiaries Age 75 to 84 | 1413 |
| Number Of Beneficiaries Age Greater 84 | 732 |
| Number Of Female Beneficiaries | 3693 |
| Number Of Male Beneficiaries | 1498 |
| Number Of Non Hispanic White Beneficiaries | 4642 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | 65 |
| Number Of Hispanic Beneficiaries | 294 |
| Number Of American Indian Alaska Native Beneficiaries | 89 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3656 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1535 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5098 |