| National Provider Identifier [NPI]: | 1821016270 |
| Last Name Of The Provider | ROSE |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8001 FORBES PL |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 221512208 |
| 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 | 171 |
| Number Of Services | 5674 |
| Number Of Medicare Beneficiaries | 3653 |
| Total Submitted Charge Amount | 1050574 |
| Total Medicare Allowed Amount | 274581.76 |
| Total Medicare Payment Amount | 222748.58 |
| Total Medicare Standardized Payment Amount | 205997.38 |
| 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 | 171 |
| Number Of Medical Services | 5674 |
| Number Of Medicare Beneficiaries With Medical Services | 3653 |
| Total Medical Submitted Charge Amount | 1050574 |
| Total Medical Medicare Allowed Amount | 274581.76 |
| Total Medical Medicare Payment Amount | 222748.58 |
| Total Medical Medicare Standardized Payment Amount | 205997.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 369 |
| Number Of Beneficiaries Age 65 to 74 | 1518 |
| Number Of Beneficiaries Age 75 to 84 | 1095 |
| Number Of Beneficiaries Age Greater 84 | 671 |
| Number Of Female Beneficiaries | 2484 |
| Number Of Male Beneficiaries | 1169 |
| Number Of Non Hispanic White Beneficiaries | 2500 |
| Number Of Black or African American Beneficiaries | 701 |
| Number Of AsianPacific Islander Beneficiaries | 169 |
| Number Of Hispanic Beneficiaries | 192 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3013 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 640 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.426 |