| National Provider Identifier [NPI]: | 1619947215 |
| Last Name Of The Provider | HINES |
| First Name Of The Provider | SUSAN |
| 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 | 865 W LAKE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOUNT AIRY |
| Zip Code Of The Provider | 270302157 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Medical Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 43255 |
| Number Of Medicare Beneficiaries | 465 |
| Total Submitted Charge Amount | 1209739.6 |
| Total Medicare Allowed Amount | 527854.9 |
| Total Medicare Payment Amount | 405020.05 |
| Total Medicare Standardized Payment Amount | 408104.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 52 |
| Number Of Drug Services | 41322 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 914144.6 |
| Total Drug Medicare AllowedAmount | 384885.03 |
| Total Drug Medicare PaymentAmount | 297996.85 |
| Total Drug Medicare Standardized Payment Amount | 297996.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 1933 |
| Number Of Medicare Beneficiaries With Medical Services | 462 |
| Total Medical Submitted Charge Amount | 295595 |
| Total Medical Medicare Allowed Amount | 142969.87 |
| Total Medical Medicare Payment Amount | 107023.2 |
| Total Medical Medicare Standardized Payment Amount | 110107.58 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 140 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 414 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 368 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 50 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7816 |