| National Provider Identifier [NPI]: | 1184692980 |
| Last Name Of The Provider | ROSE |
| First Name Of The Provider | HEATHER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 202 MAPLEWOOD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RONCEVERTE |
| Zip Code Of The Provider | 249701334 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 11213 |
| Number Of Medicare Beneficiaries | 4247 |
| Total Submitted Charge Amount | 1368852 |
| Total Medicare Allowed Amount | 330180.52 |
| Total Medicare Payment Amount | 254868.65 |
| Total Medicare Standardized Payment Amount | 268396.53 |
| 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 | 205 |
| Number Of Medical Services | 11213 |
| Number Of Medicare Beneficiaries With Medical Services | 4247 |
| Total Medical Submitted Charge Amount | 1368852 |
| Total Medical Medicare Allowed Amount | 330180.52 |
| Total Medical Medicare Payment Amount | 254868.65 |
| Total Medical Medicare Standardized Payment Amount | 268396.53 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 924 |
| Number Of Beneficiaries Age 65 to 74 | 1763 |
| Number Of Beneficiaries Age 75 to 84 | 1075 |
| Number Of Beneficiaries Age Greater 84 | 485 |
| Number Of Female Beneficiaries | 2622 |
| Number Of Male Beneficiaries | 1625 |
| Number Of Non Hispanic White Beneficiaries | 4089 |
| Number Of Black or African American Beneficiaries | 100 |
| 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 | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2806 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1441 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3145 |