| National Provider Identifier [NPI]: | 1508887175 |
| Last Name Of The Provider | SAMUELS |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1949 GUNBARREL RD |
| Street Address 2 Of The Provider | STE 170 |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374213188 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 40656 |
| Number Of Medicare Beneficiaries | 3054 |
| Total Submitted Charge Amount | 2739246.07 |
| Total Medicare Allowed Amount | 635103.28 |
| Total Medicare Payment Amount | 502821.89 |
| Total Medicare Standardized Payment Amount | 546582.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 35452 |
| Number Of Medicare Beneficiaries With Drug Services | 361 |
| Total Drug Submitted ChargeAmount | 81901.07 |
| Total Drug Medicare AllowedAmount | 11209.28 |
| Total Drug Medicare PaymentAmount | 8559.58 |
| Total Drug Medicare Standardized Payment Amount | 8559.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 181 |
| Number Of Medical Services | 5204 |
| Number Of Medicare Beneficiaries With Medical Services | 3053 |
| Total Medical Submitted Charge Amount | 2657345 |
| Total Medical Medicare Allowed Amount | 623894 |
| Total Medical Medicare Payment Amount | 494262.31 |
| Total Medical Medicare Standardized Payment Amount | 538022.88 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 677 |
| Number Of Beneficiaries Age 65 to 74 | 1325 |
| Number Of Beneficiaries Age 75 to 84 | 790 |
| Number Of Beneficiaries Age Greater 84 | 262 |
| Number Of Female Beneficiaries | 2252 |
| Number Of Male Beneficiaries | 802 |
| Number Of Non Hispanic White Beneficiaries | 2862 |
| Number Of Black or African American Beneficiaries | 147 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 825 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2678 |