| National Provider Identifier [NPI]: | 1861614539 |
| Last Name Of The Provider | LACOMBE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2525 DESALES AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374041161 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 227 |
| Number Of Services | 6295 |
| Number Of Medicare Beneficiaries | 3905 |
| Total Submitted Charge Amount | 659893 |
| Total Medicare Allowed Amount | 218031.72 |
| Total Medicare Payment Amount | 163001.53 |
| Total Medicare Standardized Payment Amount | 175530.72 |
| 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 | 227 |
| Number Of Medical Services | 6295 |
| Number Of Medicare Beneficiaries With Medical Services | 3905 |
| Total Medical Submitted Charge Amount | 659893 |
| Total Medical Medicare Allowed Amount | 218031.72 |
| Total Medical Medicare Payment Amount | 163001.53 |
| Total Medical Medicare Standardized Payment Amount | 175530.72 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 662 |
| Number Of Beneficiaries Age 65 to 74 | 1351 |
| Number Of Beneficiaries Age 75 to 84 | 1210 |
| Number Of Beneficiaries Age Greater 84 | 682 |
| Number Of Female Beneficiaries | 2199 |
| Number Of Male Beneficiaries | 1706 |
| Number Of Non Hispanic White Beneficiaries | 3480 |
| Number Of Black or African American Beneficiaries | 379 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2963 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 942 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9493 |