| National Provider Identifier [NPI]: | 1023057619 |
| Last Name Of The Provider | BLIETZ |
| First Name Of The Provider | MELINDA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1331 N ELM ST |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | GREENSBORO |
| Zip Code Of The Provider | 274016302 |
| 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 | 108 |
| Number Of Services | 7830 |
| Number Of Medicare Beneficiaries | 1862 |
| Total Submitted Charge Amount | 348888.94 |
| Total Medicare Allowed Amount | 96803.75 |
| Total Medicare Payment Amount | 71500.39 |
| Total Medicare Standardized Payment Amount | 75931.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5526 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 2656.94 |
| Total Drug Medicare AllowedAmount | 956.86 |
| Total Drug Medicare PaymentAmount | 750.19 |
| Total Drug Medicare Standardized Payment Amount | 750.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 106 |
| Number Of Medical Services | 2304 |
| Number Of Medicare Beneficiaries With Medical Services | 1861 |
| Total Medical Submitted Charge Amount | 346232 |
| Total Medical Medicare Allowed Amount | 95846.89 |
| Total Medical Medicare Payment Amount | 70750.2 |
| Total Medical Medicare Standardized Payment Amount | 75181.06 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 395 |
| Number Of Beneficiaries Age 65 to 74 | 674 |
| Number Of Beneficiaries Age 75 to 84 | 530 |
| Number Of Beneficiaries Age Greater 84 | 263 |
| Number Of Female Beneficiaries | 1069 |
| Number Of Male Beneficiaries | 793 |
| Number Of Non Hispanic White Beneficiaries | 1442 |
| Number Of Black or African American Beneficiaries | 373 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1332 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 530 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8298 |