| National Provider Identifier [NPI]: | 1831147438 |
| Last Name Of The Provider | HODGES |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 49 LAKE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREENWICH |
| Zip Code Of The Provider | 068304501 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 213 |
| Number Of Services | 5146 |
| Number Of Medicare Beneficiaries | 2657 |
| Total Submitted Charge Amount | 282182.84 |
| Total Medicare Allowed Amount | 251109.57 |
| Total Medicare Payment Amount | 194984.9 |
| Total Medicare Standardized Payment Amount | 187738.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 210.6 |
| Total Drug Medicare AllowedAmount | 29.11 |
| Total Drug Medicare PaymentAmount | 22.78 |
| Total Drug Medicare Standardized Payment Amount | 22.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 212 |
| Number Of Medical Services | 5119 |
| Number Of Medicare Beneficiaries With Medical Services | 2657 |
| Total Medical Submitted Charge Amount | 281972.24 |
| Total Medical Medicare Allowed Amount | 251080.46 |
| Total Medical Medicare Payment Amount | 194962.12 |
| Total Medical Medicare Standardized Payment Amount | 187715.56 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 999 |
| Number Of Beneficiaries Age 75 to 84 | 914 |
| Number Of Beneficiaries Age Greater 84 | 634 |
| Number Of Female Beneficiaries | 1754 |
| Number Of Male Beneficiaries | 903 |
| Number Of Non Hispanic White Beneficiaries | 2398 |
| Number Of Black or African American Beneficiaries | 64 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 95 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 58 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2321 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 336 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3729 |