| National Provider Identifier [NPI]: | 1497708804 |
| Last Name Of The Provider | FIDLER |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | Y |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2602 BUFORD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232353422 |
| 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 | 148 |
| Number Of Services | 7528 |
| Number Of Medicare Beneficiaries | 5491 |
| Total Submitted Charge Amount | 512601.45 |
| Total Medicare Allowed Amount | 162167.05 |
| Total Medicare Payment Amount | 122669.56 |
| Total Medicare Standardized Payment Amount | 125855.13 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 891 |
| Number Of Beneficiaries Age 65 to 74 | 2039 |
| Number Of Beneficiaries Age 75 to 84 | 1584 |
| Number Of Beneficiaries Age Greater 84 | 977 |
| Number Of Female Beneficiaries | 3356 |
| Number Of Male Beneficiaries | 2135 |
| Number Of Non Hispanic White Beneficiaries | 4086 |
| Number Of Black or African American Beneficiaries | 1248 |
| Number Of AsianPacific Islander Beneficiaries | 52 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 4494 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 997 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6814 |