| National Provider Identifier [NPI]: | 1063578995 |
| Last Name Of The Provider | MEZHERITSKIY |
| First Name Of The Provider | IRINA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1350 S HICKORY ST |
| Street Address 2 Of The Provider | HOLMES REGIONAL MEDICAL CENTER/RADIOLOGY |
| City Of The Provider | MELBOURNE |
| Zip Code Of The Provider | 329013224 |
| 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 | 145 |
| Number Of Services | 5423 |
| Number Of Medicare Beneficiaries | 3311 |
| Total Submitted Charge Amount | 420575 |
| Total Medicare Allowed Amount | 142882.83 |
| Total Medicare Payment Amount | 113333.43 |
| Total Medicare Standardized Payment Amount | 113735.17 |
| 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 | 145 |
| Number Of Medical Services | 5423 |
| Number Of Medicare Beneficiaries With Medical Services | 3311 |
| Total Medical Submitted Charge Amount | 420575 |
| Total Medical Medicare Allowed Amount | 142882.83 |
| Total Medical Medicare Payment Amount | 113333.43 |
| Total Medical Medicare Standardized Payment Amount | 113735.17 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 492 |
| Number Of Beneficiaries Age 65 to 74 | 1205 |
| Number Of Beneficiaries Age 75 to 84 | 1085 |
| Number Of Beneficiaries Age Greater 84 | 529 |
| Number Of Female Beneficiaries | 2290 |
| Number Of Male Beneficiaries | 1021 |
| Number Of Non Hispanic White Beneficiaries | 2843 |
| Number Of Black or African American Beneficiaries | 241 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 143 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2736 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 575 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6444 |