| National Provider Identifier [NPI]: | 1558387365 |
| Last Name Of The Provider | ROTH |
| First Name Of The Provider | TODD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4420 LAKE BOONE TRL |
| Street Address 2 Of The Provider | |
| City Of The Provider | RALEIGH |
| Zip Code Of The Provider | 276077505 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 3914 |
| Number Of Medicare Beneficiaries | 2433 |
| Total Submitted Charge Amount | 668499.6 |
| Total Medicare Allowed Amount | 170864.93 |
| Total Medicare Payment Amount | 138215.49 |
| Total Medicare Standardized Payment Amount | 147383.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 266 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 2482.6 |
| Total Drug Medicare AllowedAmount | 128.55 |
| Total Drug Medicare PaymentAmount | 95.75 |
| Total Drug Medicare Standardized Payment Amount | 95.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 132 |
| Number Of Medical Services | 3648 |
| Number Of Medicare Beneficiaries With Medical Services | 2433 |
| Total Medical Submitted Charge Amount | 666017 |
| Total Medical Medicare Allowed Amount | 170736.38 |
| Total Medical Medicare Payment Amount | 138119.74 |
| Total Medical Medicare Standardized Payment Amount | 147287.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 325 |
| Number Of Beneficiaries Age 65 to 74 | 1147 |
| Number Of Beneficiaries Age 75 to 84 | 638 |
| Number Of Beneficiaries Age Greater 84 | 323 |
| Number Of Female Beneficiaries | 1651 |
| Number Of Male Beneficiaries | 782 |
| Number Of Non Hispanic White Beneficiaries | 1922 |
| Number Of Black or African American Beneficiaries | 388 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2079 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 354 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3623 |