| National Provider Identifier [NPI]: | 1962472217 |
| Last Name Of The Provider | KONDROSKI |
| First Name Of The Provider | ELAINE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1344 S APOLLO BLVD |
| Street Address 2 Of The Provider | STE 102 |
| City Of The Provider | MELBOURNE |
| Zip Code Of The Provider | 329013183 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 23343.5 |
| Number Of Medicare Beneficiaries | 2098 |
| Total Submitted Charge Amount | 1555121.76 |
| Total Medicare Allowed Amount | 637334.35 |
| Total Medicare Payment Amount | 513450 |
| Total Medicare Standardized Payment Amount | 524397.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 17781.5 |
| Number Of Medicare Beneficiaries With Drug Services | 200 |
| Total Drug Submitted ChargeAmount | 20302.9 |
| Total Drug Medicare AllowedAmount | 7595.23 |
| Total Drug Medicare PaymentAmount | 5940.86 |
| Total Drug Medicare Standardized Payment Amount | 5940.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 5562 |
| Number Of Medicare Beneficiaries With Medical Services | 2095 |
| Total Medical Submitted Charge Amount | 1534818.86 |
| Total Medical Medicare Allowed Amount | 629739.12 |
| Total Medical Medicare Payment Amount | 507509.14 |
| Total Medical Medicare Standardized Payment Amount | 518456.93 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 283 |
| Number Of Beneficiaries Age 65 to 74 | 893 |
| Number Of Beneficiaries Age 75 to 84 | 678 |
| Number Of Beneficiaries Age Greater 84 | 244 |
| Number Of Female Beneficiaries | 1666 |
| Number Of Male Beneficiaries | 432 |
| Number Of Non Hispanic White Beneficiaries | 1737 |
| Number Of Black or African American Beneficiaries | 185 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 118 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1788 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 310 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1175 |