| National Provider Identifier [NPI]: | 1750358750 |
| Last Name Of The Provider | SOUTHALL |
| First Name Of The Provider | KIRBY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5609 CLAIBORNE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SUTHERLAND |
| Zip Code Of The Provider | 238859303 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2683 |
| Number Of Medicare Beneficiaries | 707 |
| Total Submitted Charge Amount | 232400 |
| Total Medicare Allowed Amount | 192915.78 |
| Total Medicare Payment Amount | 127516.14 |
| Total Medicare Standardized Payment Amount | 131264.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 270 |
| Number Of Medicare Beneficiaries With Drug Services | 244 |
| Total Drug Submitted ChargeAmount | 11045 |
| Total Drug Medicare AllowedAmount | 5827.06 |
| Total Drug Medicare PaymentAmount | 5622.2 |
| Total Drug Medicare Standardized Payment Amount | 5622.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 2413 |
| Number Of Medicare Beneficiaries With Medical Services | 707 |
| Total Medical Submitted Charge Amount | 221355 |
| Total Medical Medicare Allowed Amount | 187088.72 |
| Total Medical Medicare Payment Amount | 121893.94 |
| Total Medical Medicare Standardized Payment Amount | 125642.2 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 339 |
| Number Of Beneficiaries Age 75 to 84 | 214 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 408 |
| Number Of Male Beneficiaries | 299 |
| Number Of Non Hispanic White Beneficiaries | 592 |
| 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 | 663 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9557 |