| National Provider Identifier [NPI]: | 1417989740 |
| Last Name Of The Provider | COUNCE |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 SOUTHLAKE PARK STE 200 |
| Street Address 2 Of The Provider | SUITE 400B |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352445700 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 34372 |
| Number Of Medicare Beneficiaries | 561 |
| Total Submitted Charge Amount | 658567.7 |
| Total Medicare Allowed Amount | 435458.63 |
| Total Medicare Payment Amount | 313918.2 |
| Total Medicare Standardized Payment Amount | 336352.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 31872 |
| Number Of Medicare Beneficiaries With Drug Services | 113 |
| Total Drug Submitted ChargeAmount | 225875 |
| Total Drug Medicare AllowedAmount | 174695.82 |
| Total Drug Medicare PaymentAmount | 134600.37 |
| Total Drug Medicare Standardized Payment Amount | 134600.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2500 |
| Number Of Medicare Beneficiaries With Medical Services | 561 |
| Total Medical Submitted Charge Amount | 432692.7 |
| Total Medical Medicare Allowed Amount | 260762.81 |
| Total Medical Medicare Payment Amount | 179317.83 |
| Total Medical Medicare Standardized Payment Amount | 201751.88 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 188 |
| Number Of Beneficiaries Age 65 to 74 | 203 |
| Number Of Beneficiaries Age 75 to 84 | 133 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 388 |
| Number Of Male Beneficiaries | 173 |
| Number Of Non Hispanic White Beneficiaries | 520 |
| 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 | 498 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.2157 |