| National Provider Identifier [NPI]: | 1225054216 |
| Last Name Of The Provider | ORIG |
| First Name Of The Provider | MARIA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 157 CLINIC AVE |
| Street Address 2 Of The Provider | STE 203 |
| City Of The Provider | CARROLLTON |
| Zip Code Of The Provider | 30117 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 4537 |
| Number Of Medicare Beneficiaries | 906 |
| Total Submitted Charge Amount | 498773.25 |
| Total Medicare Allowed Amount | 394512.89 |
| Total Medicare Payment Amount | 291491.7 |
| Total Medicare Standardized Payment Amount | 305070.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 720 |
| Total Drug Medicare AllowedAmount | 552.2 |
| Total Drug Medicare PaymentAmount | 541.09 |
| Total Drug Medicare Standardized Payment Amount | 541.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 4501 |
| Number Of Medicare Beneficiaries With Medical Services | 906 |
| Total Medical Submitted Charge Amount | 498053.25 |
| Total Medical Medicare Allowed Amount | 393960.69 |
| Total Medical Medicare Payment Amount | 290950.61 |
| Total Medical Medicare Standardized Payment Amount | 304529.7 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 222 |
| Number Of Beneficiaries Age 65 to 74 | 311 |
| Number Of Beneficiaries Age 75 to 84 | 273 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 503 |
| Number Of Male Beneficiaries | 403 |
| Number Of Non Hispanic White Beneficiaries | 682 |
| Number Of Black or African American Beneficiaries | 198 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 604 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 302 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 66 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 3.3803 |