| National Provider Identifier [NPI]: | 1225060833 |
| Last Name Of The Provider | REYNOLDS |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 MEDICAL PARK DR |
| Street Address 2 Of The Provider | SUITE 304 |
| City Of The Provider | HARTSVILLE |
| Zip Code Of The Provider | 295504777 |
| State Code Of The Provider | SC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 5607 |
| Number Of Medicare Beneficiaries | 386 |
| Total Submitted Charge Amount | 527855.56 |
| Total Medicare Allowed Amount | 245090.64 |
| Total Medicare Payment Amount | 175953.46 |
| Total Medicare Standardized Payment Amount | 188836.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 516 |
| Number Of Medicare Beneficiaries With Drug Services | 72 |
| Total Drug Submitted ChargeAmount | 16624.6 |
| Total Drug Medicare AllowedAmount | 6517.09 |
| Total Drug Medicare PaymentAmount | 5202.75 |
| Total Drug Medicare Standardized Payment Amount | 5202.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 5091 |
| Number Of Medicare Beneficiaries With Medical Services | 386 |
| Total Medical Submitted Charge Amount | 511230.96 |
| Total Medical Medicare Allowed Amount | 238573.55 |
| Total Medical Medicare Payment Amount | 170750.71 |
| Total Medical Medicare Standardized Payment Amount | 183633.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 146 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 71 |
| Number Of Non Hispanic White Beneficiaries | 280 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 330 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0756 |