| National Provider Identifier [NPI]: | 1215966726 |
| Last Name Of The Provider | JORDANOV |
| First Name Of The Provider | MARTIN |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1161 21ST AVE S |
| Street Address 2 Of The Provider | CCC-1121 MCN |
| City Of The Provider | NASHVILLE |
| Zip Code Of The Provider | 372322675 |
| 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 | 102 |
| Number Of Services | 5632 |
| Number Of Medicare Beneficiaries | 2764 |
| Total Submitted Charge Amount | 675044 |
| Total Medicare Allowed Amount | 128495.19 |
| Total Medicare Payment Amount | 96159.42 |
| Total Medicare Standardized Payment Amount | 106934.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1073 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 6914 |
| Total Drug Medicare AllowedAmount | 950 |
| Total Drug Medicare PaymentAmount | 733.53 |
| Total Drug Medicare Standardized Payment Amount | 733.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 4559 |
| Number Of Medicare Beneficiaries With Medical Services | 2764 |
| Total Medical Submitted Charge Amount | 668130 |
| Total Medical Medicare Allowed Amount | 127545.19 |
| Total Medical Medicare Payment Amount | 95425.89 |
| Total Medical Medicare Standardized Payment Amount | 106200.79 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 723 |
| Number Of Beneficiaries Age 65 to 74 | 1232 |
| Number Of Beneficiaries Age 75 to 84 | 609 |
| Number Of Beneficiaries Age Greater 84 | 200 |
| Number Of Female Beneficiaries | 1589 |
| Number Of Male Beneficiaries | 1175 |
| Number Of Non Hispanic White Beneficiaries | 2419 |
| Number Of Black or African American Beneficiaries | 265 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2206 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 558 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.629 |