| National Provider Identifier [NPI]: | 1780686352 |
| Last Name Of The Provider | TUMMINELLO |
| First Name Of The Provider | SAM |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19 SERGEANT PRENTISS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NATCHEZ |
| Zip Code Of The Provider | 391204727 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 6719 |
| Number Of Medicare Beneficiaries | 2068 |
| Total Submitted Charge Amount | 369139.61 |
| Total Medicare Allowed Amount | 346554.57 |
| Total Medicare Payment Amount | 235305.83 |
| Total Medicare Standardized Payment Amount | 259278.64 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 809 |
| Number Of Beneficiaries Age 75 to 84 | 805 |
| Number Of Beneficiaries Age Greater 84 | 317 |
| Number Of Female Beneficiaries | 1081 |
| Number Of Male Beneficiaries | 987 |
| Number Of Non Hispanic White Beneficiaries | 1858 |
| Number Of Black or African American Beneficiaries | 192 |
| 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 | 1784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 284 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9743 |