| National Provider Identifier [NPI]: | 1548443716 |
| Last Name Of The Provider | ZOLLINGER |
| First Name Of The Provider | LAUREN |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D., M.P.H. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 E 3900 S |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPARTMENT |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841241300 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 5811 |
| Number Of Medicare Beneficiaries | 3075 |
| Total Submitted Charge Amount | 714124.19 |
| Total Medicare Allowed Amount | 213134.76 |
| Total Medicare Payment Amount | 157290.23 |
| Total Medicare Standardized Payment Amount | 166303.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1249 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 5705.2 |
| Total Drug Medicare AllowedAmount | 649.34 |
| Total Drug Medicare PaymentAmount | 463.03 |
| Total Drug Medicare Standardized Payment Amount | 463.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 4562 |
| Number Of Medicare Beneficiaries With Medical Services | 3075 |
| Total Medical Submitted Charge Amount | 708418.99 |
| Total Medical Medicare Allowed Amount | 212485.42 |
| Total Medical Medicare Payment Amount | 156827.2 |
| Total Medical Medicare Standardized Payment Amount | 165840.84 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 405 |
| Number Of Beneficiaries Age 65 to 74 | 1064 |
| Number Of Beneficiaries Age 75 to 84 | 1005 |
| Number Of Beneficiaries Age Greater 84 | 601 |
| Number Of Female Beneficiaries | 1836 |
| Number Of Male Beneficiaries | 1239 |
| Number Of Non Hispanic White Beneficiaries | 2820 |
| Number Of Black or African American Beneficiaries | 32 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2682 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 393 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.403 |