| National Provider Identifier [NPI]: | 1649220856 |
| Last Name Of The Provider | LEI |
| First Name Of The Provider | XIA |
| 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 | 5301 S CONGRESS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATLANTIS |
| Zip Code Of The Provider | 334621149 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 213 |
| Number Of Services | 47811 |
| Number Of Medicare Beneficiaries | 3433 |
| Total Submitted Charge Amount | 3648925.71 |
| Total Medicare Allowed Amount | 1408735.08 |
| Total Medicare Payment Amount | 1094884.34 |
| Total Medicare Standardized Payment Amount | 1119059.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 42520 |
| Number Of Medicare Beneficiaries With Drug Services | 814 |
| Total Drug Submitted ChargeAmount | 73915.85 |
| Total Drug Medicare AllowedAmount | 20346.64 |
| Total Drug Medicare PaymentAmount | 15658.31 |
| Total Drug Medicare Standardized Payment Amount | 15658.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 203 |
| Number Of Medical Services | 5291 |
| Number Of Medicare Beneficiaries With Medical Services | 3424 |
| Total Medical Submitted Charge Amount | 3575009.86 |
| Total Medical Medicare Allowed Amount | 1388388.44 |
| Total Medical Medicare Payment Amount | 1079226.03 |
| Total Medical Medicare Standardized Payment Amount | 1103401.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 355 |
| Number Of Beneficiaries Age 65 to 74 | 1625 |
| Number Of Beneficiaries Age 75 to 84 | 1123 |
| Number Of Beneficiaries Age Greater 84 | 330 |
| Number Of Female Beneficiaries | 2006 |
| Number Of Male Beneficiaries | 1427 |
| Number Of Non Hispanic White Beneficiaries | 3147 |
| Number Of Black or African American Beneficiaries | 116 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3075 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 358 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3611 |