| National Provider Identifier [NPI]: | 1912136946 |
| Last Name Of The Provider | LIGHT |
| First Name Of The Provider | RYAN |
| 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 | 1100 VOLVO PKWY |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CHESAPEAKE |
| Zip Code Of The Provider | 233203341 |
| 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 | 73 |
| Number Of Services | 1805 |
| Number Of Medicare Beneficiaries | 148 |
| Total Submitted Charge Amount | 177645 |
| Total Medicare Allowed Amount | 77172.35 |
| Total Medicare Payment Amount | 58202.99 |
| Total Medicare Standardized Payment Amount | 59225.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 60 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 2854 |
| Total Drug Medicare AllowedAmount | 1407.92 |
| Total Drug Medicare PaymentAmount | 1378.95 |
| Total Drug Medicare Standardized Payment Amount | 1378.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 1745 |
| Number Of Medicare Beneficiaries With Medical Services | 148 |
| Total Medical Submitted Charge Amount | 174791 |
| Total Medical Medicare Allowed Amount | 75764.43 |
| Total Medical Medicare Payment Amount | 56824.04 |
| Total Medical Medicare Standardized Payment Amount | 57846.11 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 39 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 88 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 114 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 133 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0663 |