| National Provider Identifier [NPI]: | 1295727352 |
| Last Name Of The Provider | DEPERSIA |
| First Name Of The Provider | LORI |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1648 HUNTINGDON PIKE |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | MEADOWBROOK |
| Zip Code Of The Provider | 190468001 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 179 |
| Number Of Services | 5025 |
| Number Of Medicare Beneficiaries | 3039 |
| Total Submitted Charge Amount | 648980 |
| Total Medicare Allowed Amount | 172630.01 |
| Total Medicare Payment Amount | 133772.23 |
| Total Medicare Standardized Payment Amount | 129919.62 |
| 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 | 179 |
| Number Of Medical Services | 5025 |
| Number Of Medicare Beneficiaries With Medical Services | 3039 |
| Total Medical Submitted Charge Amount | 648980 |
| Total Medical Medicare Allowed Amount | 172630.01 |
| Total Medical Medicare Payment Amount | 133772.23 |
| Total Medical Medicare Standardized Payment Amount | 129919.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 632 |
| Number Of Beneficiaries Age 65 to 74 | 910 |
| Number Of Beneficiaries Age 75 to 84 | 809 |
| Number Of Beneficiaries Age Greater 84 | 688 |
| Number Of Female Beneficiaries | 1859 |
| Number Of Male Beneficiaries | 1180 |
| Number Of Non Hispanic White Beneficiaries | 2335 |
| Number Of Black or African American Beneficiaries | 494 |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 117 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2057 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 982 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.1303 |