| National Provider Identifier [NPI]: | 1811982382 |
| Last Name Of The Provider | LAMONT |
| First Name Of The Provider | ALLISON |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 W EDISON RD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | MISHAWAKA |
| Zip Code Of The Provider | 465452784 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 6122 |
| Number Of Medicare Beneficiaries | 3224 |
| Total Submitted Charge Amount | 767391.39 |
| Total Medicare Allowed Amount | 161774.7 |
| Total Medicare Payment Amount | 128691.73 |
| Total Medicare Standardized Payment Amount | 135898.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 369 |
| Number Of Medicare Beneficiaries With Drug Services | 28 |
| Total Drug Submitted ChargeAmount | 809.92 |
| Total Drug Medicare AllowedAmount | 806.11 |
| Total Drug Medicare PaymentAmount | 632 |
| Total Drug Medicare Standardized Payment Amount | 632 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 5753 |
| Number Of Medicare Beneficiaries With Medical Services | 3224 |
| Total Medical Submitted Charge Amount | 766581.47 |
| Total Medical Medicare Allowed Amount | 160968.59 |
| Total Medical Medicare Payment Amount | 128059.73 |
| Total Medical Medicare Standardized Payment Amount | 135266.94 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 489 |
| Number Of Beneficiaries Age 65 to 74 | 1407 |
| Number Of Beneficiaries Age 75 to 84 | 940 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 2486 |
| Number Of Male Beneficiaries | 738 |
| Number Of Non Hispanic White Beneficiaries | 2903 |
| Number Of Black or African American Beneficiaries | 220 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2532 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 692 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2698 |