| National Provider Identifier [NPI]: | 1861411084 |
| Last Name Of The Provider | DESHIELDS |
| First Name Of The Provider | LAURENCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 S COLUMBUS ST |
| Street Address 2 Of The Provider | #106 |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 223144289 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 1429 |
| Number Of Medicare Beneficiaries | 660 |
| Total Submitted Charge Amount | 174674.48 |
| Total Medicare Allowed Amount | 170518.71 |
| Total Medicare Payment Amount | 129421.71 |
| Total Medicare Standardized Payment Amount | 135002.46 |
| 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 | 30 |
| Number Of Medical Services | 1429 |
| Number Of Medicare Beneficiaries With Medical Services | 660 |
| Total Medical Submitted Charge Amount | 174674.48 |
| Total Medical Medicare Allowed Amount | 170518.71 |
| Total Medical Medicare Payment Amount | 129421.71 |
| Total Medical Medicare Standardized Payment Amount | 135002.46 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 210 |
| Number Of Beneficiaries Age Greater 84 | 159 |
| Number Of Female Beneficiaries | 363 |
| Number Of Male Beneficiaries | 297 |
| Number Of Non Hispanic White Beneficiaries | 510 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 405 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 255 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.0642 |