| National Provider Identifier [NPI]: | 1255302121 |
| Last Name Of The Provider | CASANOVA |
| First Name Of The Provider | VELMA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20410 OBSERVATION DR |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | GERMANTOWN |
| Zip Code Of The Provider | 208764000 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 131 |
| Number Of Services | 27319 |
| Number Of Medicare Beneficiaries | 2852 |
| Total Submitted Charge Amount | 1040315.15 |
| Total Medicare Allowed Amount | 405621.1 |
| Total Medicare Payment Amount | 323686.75 |
| Total Medicare Standardized Payment Amount | 283307.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 22738 |
| Number Of Medicare Beneficiaries With Drug Services | 205 |
| Total Drug Submitted ChargeAmount | 24508.65 |
| Total Drug Medicare AllowedAmount | 4889.23 |
| Total Drug Medicare PaymentAmount | 3820.01 |
| Total Drug Medicare Standardized Payment Amount | 3820.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 128 |
| Number Of Medical Services | 4581 |
| Number Of Medicare Beneficiaries With Medical Services | 2852 |
| Total Medical Submitted Charge Amount | 1015806.5 |
| Total Medical Medicare Allowed Amount | 400731.87 |
| Total Medical Medicare Payment Amount | 319866.74 |
| Total Medical Medicare Standardized Payment Amount | 279487.79 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 304 |
| Number Of Beneficiaries Age 65 to 74 | 1167 |
| Number Of Beneficiaries Age 75 to 84 | 882 |
| Number Of Beneficiaries Age Greater 84 | 499 |
| Number Of Female Beneficiaries | 1957 |
| Number Of Male Beneficiaries | 895 |
| Number Of Non Hispanic White Beneficiaries | 1651 |
| Number Of Black or African American Beneficiaries | 370 |
| Number Of AsianPacific Islander Beneficiaries | 518 |
| Number Of Hispanic Beneficiaries | 231 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1917 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 935 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4315 |