| National Provider Identifier [NPI]: | 1033166335 |
| Last Name Of The Provider | TRINIDAD |
| First Name Of The Provider | SALVADOR |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 736 BATTLEFIELD BLVD N |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | CHESAPEAKE |
| Zip Code Of The Provider | 233204941 |
| 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 | 161 |
| Number Of Services | 4981 |
| Number Of Medicare Beneficiaries | 2007 |
| Total Submitted Charge Amount | 709499.76 |
| Total Medicare Allowed Amount | 172930.81 |
| Total Medicare Payment Amount | 132886.99 |
| Total Medicare Standardized Payment Amount | 138316.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2062 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 2490.76 |
| Total Drug Medicare AllowedAmount | 1208.33 |
| Total Drug Medicare PaymentAmount | 883.49 |
| Total Drug Medicare Standardized Payment Amount | 883.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 2919 |
| Number Of Medicare Beneficiaries With Medical Services | 2007 |
| Total Medical Submitted Charge Amount | 707009 |
| Total Medical Medicare Allowed Amount | 171722.48 |
| Total Medical Medicare Payment Amount | 132003.5 |
| Total Medical Medicare Standardized Payment Amount | 137433.11 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 324 |
| Number Of Beneficiaries Age 65 to 74 | 822 |
| Number Of Beneficiaries Age 75 to 84 | 562 |
| Number Of Beneficiaries Age Greater 84 | 299 |
| Number Of Female Beneficiaries | 1269 |
| Number Of Male Beneficiaries | 738 |
| Number Of Non Hispanic White Beneficiaries | 1404 |
| Number Of Black or African American Beneficiaries | 505 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1634 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 373 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.6466 |