| National Provider Identifier [NPI]: | 1134172315 |
| Last Name Of The Provider | LOMIS |
| First Name Of The Provider | NICK |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3628 CAPE CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FAYETTEVILLE |
| Zip Code Of The Provider | 283044406 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 188 |
| Number Of Services | 26313 |
| Number Of Medicare Beneficiaries | 5702 |
| Total Submitted Charge Amount | 1624754.86 |
| Total Medicare Allowed Amount | 496275.1 |
| Total Medicare Payment Amount | 383434.09 |
| Total Medicare Standardized Payment Amount | 368182.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 17761 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 5061.5 |
| Total Drug Medicare AllowedAmount | 3874.59 |
| Total Drug Medicare PaymentAmount | 2835.16 |
| Total Drug Medicare Standardized Payment Amount | 2835.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 186 |
| Number Of Medical Services | 8552 |
| Number Of Medicare Beneficiaries With Medical Services | 5702 |
| Total Medical Submitted Charge Amount | 1619693.36 |
| Total Medical Medicare Allowed Amount | 492400.51 |
| Total Medical Medicare Payment Amount | 380598.93 |
| Total Medical Medicare Standardized Payment Amount | 365347.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 824 |
| Number Of Beneficiaries Age 65 to 74 | 2235 |
| Number Of Beneficiaries Age 75 to 84 | 1737 |
| Number Of Beneficiaries Age Greater 84 | 906 |
| Number Of Female Beneficiaries | 3523 |
| Number Of Male Beneficiaries | 2179 |
| Number Of Non Hispanic White Beneficiaries | 4946 |
| Number Of Black or African American Beneficiaries | 561 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 63 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 78 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4809 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 893 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.5359 |