| National Provider Identifier [NPI]: | 1285815787 |
| Last Name Of The Provider | LOPEZ |
| First Name Of The Provider | MARTHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 65 SOCKANOSSET CROSS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CRANSTON |
| Zip Code Of The Provider | 029205536 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 12072 |
| Number Of Medicare Beneficiaries | 2851 |
| Total Submitted Charge Amount | 1180386 |
| Total Medicare Allowed Amount | 264057.55 |
| Total Medicare Payment Amount | 204230.68 |
| Total Medicare Standardized Payment Amount | 199640.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 7735 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 9441 |
| Total Drug Medicare AllowedAmount | 2539.12 |
| Total Drug Medicare PaymentAmount | 1990.64 |
| Total Drug Medicare Standardized Payment Amount | 1990.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 159 |
| Number Of Medical Services | 4337 |
| Number Of Medicare Beneficiaries With Medical Services | 2851 |
| Total Medical Submitted Charge Amount | 1170945 |
| Total Medical Medicare Allowed Amount | 261518.43 |
| Total Medical Medicare Payment Amount | 202240.04 |
| Total Medical Medicare Standardized Payment Amount | 197649.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 556 |
| Number Of Beneficiaries Age 65 to 74 | 1060 |
| Number Of Beneficiaries Age 75 to 84 | 693 |
| Number Of Beneficiaries Age Greater 84 | 542 |
| Number Of Female Beneficiaries | 1865 |
| Number Of Male Beneficiaries | 986 |
| Number Of Non Hispanic White Beneficiaries | 2629 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 104 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2088 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 763 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5202 |