| National Provider Identifier [NPI]: | 1063421295 |
| Last Name Of The Provider | LACH |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 COLCHESTER AVE |
| Street Address 2 Of The Provider | FLETCHER ALLEN HEALTH CARE |
| City Of The Provider | BURLINGTON |
| Zip Code Of The Provider | 054011473 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 2092 |
| Number Of Medicare Beneficiaries | 1283 |
| Total Submitted Charge Amount | 474859 |
| Total Medicare Allowed Amount | 66982.98 |
| Total Medicare Payment Amount | 48881.87 |
| Total Medicare Standardized Payment Amount | 49775.94 |
| 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 | 95 |
| Number Of Medical Services | 2092 |
| Number Of Medicare Beneficiaries With Medical Services | 1283 |
| Total Medical Submitted Charge Amount | 474859 |
| Total Medical Medicare Allowed Amount | 66982.98 |
| Total Medical Medicare Payment Amount | 48881.87 |
| Total Medical Medicare Standardized Payment Amount | 49775.94 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 263 |
| Number Of Beneficiaries Age 65 to 74 | 565 |
| Number Of Beneficiaries Age 75 to 84 | 332 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 743 |
| Number Of Male Beneficiaries | 540 |
| Number Of Non Hispanic White Beneficiaries | 1232 |
| Number Of Black or African American Beneficiaries | |
| 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 | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1008 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 275 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.151 |