| National Provider Identifier [NPI]: | 1467443606 |
| Last Name Of The Provider | MOUNT |
| First Name Of The Provider | LISA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4237 RIVER HILLS DR |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | LITTLE RIVER |
| Zip Code Of The Provider | 295666444 |
| 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 | 57 |
| Number Of Services | 6982 |
| Number Of Medicare Beneficiaries | 1220 |
| Total Submitted Charge Amount | 824309 |
| Total Medicare Allowed Amount | 397128.89 |
| Total Medicare Payment Amount | 281466.51 |
| Total Medicare Standardized Payment Amount | 299901.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 780 |
| Number Of Medicare Beneficiaries With Drug Services | 479 |
| Total Drug Submitted ChargeAmount | 52345 |
| Total Drug Medicare AllowedAmount | 19750.36 |
| Total Drug Medicare PaymentAmount | 19058.47 |
| Total Drug Medicare Standardized Payment Amount | 19058.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 6202 |
| Number Of Medicare Beneficiaries With Medical Services | 1220 |
| Total Medical Submitted Charge Amount | 771964 |
| Total Medical Medicare Allowed Amount | 377378.53 |
| Total Medical Medicare Payment Amount | 262408.04 |
| Total Medical Medicare Standardized Payment Amount | 280843.5 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 528 |
| Number Of Beneficiaries Age 75 to 84 | 475 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 799 |
| Number Of Male Beneficiaries | 421 |
| Number Of Non Hispanic White Beneficiaries | 1173 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 1191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9921 |