| National Provider Identifier [NPI]: | 1619931326 |
| Last Name Of The Provider | GUBERNICK |
| First Name Of The Provider | JULIE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5501 OLD YORK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191413018 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 158 |
| Number Of Services | 6325 |
| Number Of Medicare Beneficiaries | 2950 |
| Total Submitted Charge Amount | 743111 |
| Total Medicare Allowed Amount | 198720.53 |
| Total Medicare Payment Amount | 151832.59 |
| Total Medicare Standardized Payment Amount | 154594.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2242 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 6175 |
| Total Drug Medicare AllowedAmount | 442.62 |
| Total Drug Medicare PaymentAmount | 346.94 |
| Total Drug Medicare Standardized Payment Amount | 346.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 155 |
| Number Of Medical Services | 4083 |
| Number Of Medicare Beneficiaries With Medical Services | 2950 |
| Total Medical Submitted Charge Amount | 736936 |
| Total Medical Medicare Allowed Amount | 198277.91 |
| Total Medical Medicare Payment Amount | 151485.65 |
| Total Medical Medicare Standardized Payment Amount | 154247.58 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 490 |
| Number Of Beneficiaries Age 65 to 74 | 994 |
| Number Of Beneficiaries Age 75 to 84 | 865 |
| Number Of Beneficiaries Age Greater 84 | 601 |
| Number Of Female Beneficiaries | 1612 |
| Number Of Male Beneficiaries | 1338 |
| Number Of Non Hispanic White Beneficiaries | 2530 |
| Number Of Black or African American Beneficiaries | 243 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 101 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 621 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9056 |