| National Provider Identifier [NPI]: | 1235138421 |
| Last Name Of The Provider | CORMIER |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3800 RESERVOIR RD NW |
| Street Address 2 Of The Provider | |
| City Of The Provider | WASHINGTON |
| Zip Code Of The Provider | 200072113 |
| State Code Of The Provider | DC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 5338 |
| Number Of Medicare Beneficiaries | 3090 |
| Total Submitted Charge Amount | 396839 |
| Total Medicare Allowed Amount | 141061.15 |
| Total Medicare Payment Amount | 106022.27 |
| Total Medicare Standardized Payment Amount | 93391.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 5338 |
| Number Of Medicare Beneficiaries With Medical Services | 3090 |
| Total Medical Submitted Charge Amount | 396839 |
| Total Medical Medicare Allowed Amount | 141061.15 |
| Total Medical Medicare Payment Amount | 106022.27 |
| Total Medical Medicare Standardized Payment Amount | 93391.09 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 572 |
| Number Of Beneficiaries Age 65 to 74 | 1316 |
| Number Of Beneficiaries Age 75 to 84 | 848 |
| Number Of Beneficiaries Age Greater 84 | 354 |
| Number Of Female Beneficiaries | 1789 |
| Number Of Male Beneficiaries | 1301 |
| Number Of Non Hispanic White Beneficiaries | 1796 |
| Number Of Black or African American Beneficiaries | 1041 |
| Number Of AsianPacific Islander Beneficiaries | 89 |
| Number Of Hispanic Beneficiaries | 102 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 62 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2383 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 707 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9998 |