| National Provider Identifier [NPI]: | 1457342701 |
| Last Name Of The Provider | DOVER |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1331 NORTH ELM STREET |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | GREENSBORO |
| Zip Code Of The Provider | 274016304 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 10430 |
| Number Of Medicare Beneficiaries | 4300 |
| Total Submitted Charge Amount | 572385.18 |
| Total Medicare Allowed Amount | 166350.43 |
| Total Medicare Payment Amount | 123714.64 |
| Total Medicare Standardized Payment Amount | 130799.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4597 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 2015.18 |
| Total Drug Medicare AllowedAmount | 868.1 |
| Total Drug Medicare PaymentAmount | 680.65 |
| Total Drug Medicare Standardized Payment Amount | 680.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 161 |
| Number Of Medical Services | 5833 |
| Number Of Medicare Beneficiaries With Medical Services | 4300 |
| Total Medical Submitted Charge Amount | 570370 |
| Total Medical Medicare Allowed Amount | 165482.33 |
| Total Medical Medicare Payment Amount | 123033.99 |
| Total Medical Medicare Standardized Payment Amount | 130119.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1033 |
| Number Of Beneficiaries Age 65 to 74 | 1410 |
| Number Of Beneficiaries Age 75 to 84 | 1162 |
| Number Of Beneficiaries Age Greater 84 | 695 |
| Number Of Female Beneficiaries | 2531 |
| Number Of Male Beneficiaries | 1769 |
| Number Of Non Hispanic White Beneficiaries | 3269 |
| Number Of Black or African American Beneficiaries | 919 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2905 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1395 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8622 |