| National Provider Identifier [NPI]: | 1871540542 |
| Last Name Of The Provider | MEDINA |
| First Name Of The Provider | JOCELYN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1301 SUNSET DR |
| Street Address 2 Of The Provider | STE 3 |
| City Of The Provider | JOHNSON CITY |
| Zip Code Of The Provider | 376047906 |
| 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 | 205 |
| Number Of Services | 4040 |
| Number Of Medicare Beneficiaries | 2674 |
| Total Submitted Charge Amount | 422429 |
| Total Medicare Allowed Amount | 118637.41 |
| Total Medicare Payment Amount | 91866.04 |
| Total Medicare Standardized Payment Amount | 98914.04 |
| 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 | 205 |
| Number Of Medical Services | 4040 |
| Number Of Medicare Beneficiaries With Medical Services | 2674 |
| Total Medical Submitted Charge Amount | 422429 |
| Total Medical Medicare Allowed Amount | 118637.41 |
| Total Medical Medicare Payment Amount | 91866.04 |
| Total Medical Medicare Standardized Payment Amount | 98914.04 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 600 |
| Number Of Beneficiaries Age 65 to 74 | 1009 |
| Number Of Beneficiaries Age 75 to 84 | 718 |
| Number Of Beneficiaries Age Greater 84 | 347 |
| Number Of Female Beneficiaries | 1842 |
| Number Of Male Beneficiaries | 832 |
| Number Of Non Hispanic White Beneficiaries | 2597 |
| Number Of Black or African American Beneficiaries | 42 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1858 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 816 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5851 |