| National Provider Identifier [NPI]: | 1689627911 |
| Last Name Of The Provider | D'HAEM |
| First Name Of The Provider | ROBERT |
| 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 | 2800 GODWIN BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SUFFOLK |
| Zip Code Of The Provider | 234348038 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 235 |
| Number Of Services | 8066 |
| Number Of Medicare Beneficiaries | 4730 |
| Total Submitted Charge Amount | 799454 |
| Total Medicare Allowed Amount | 227907.72 |
| Total Medicare Payment Amount | 170343.86 |
| Total Medicare Standardized Payment Amount | 174498.07 |
| 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 | 235 |
| Number Of Medical Services | 8066 |
| Number Of Medicare Beneficiaries With Medical Services | 4730 |
| Total Medical Submitted Charge Amount | 799454 |
| Total Medical Medicare Allowed Amount | 227907.72 |
| Total Medical Medicare Payment Amount | 170343.86 |
| Total Medical Medicare Standardized Payment Amount | 174498.07 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 848 |
| Number Of Beneficiaries Age 65 to 74 | 1788 |
| Number Of Beneficiaries Age 75 to 84 | 1359 |
| Number Of Beneficiaries Age Greater 84 | 735 |
| Number Of Female Beneficiaries | 2738 |
| Number Of Male Beneficiaries | 1992 |
| Number Of Non Hispanic White Beneficiaries | 3080 |
| Number Of Black or African American Beneficiaries | 1514 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3725 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1005 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7285 |