| National Provider Identifier [NPI]: | 1124085246 |
| Last Name Of The Provider | TAPPOUNI |
| First Name Of The Provider | RAFEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WINSTON SALEM |
| Zip Code Of The Provider | 271570001 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 3838 |
| Number Of Medicare Beneficiaries | 1098 |
| Total Submitted Charge Amount | 365786.68 |
| Total Medicare Allowed Amount | 95374.71 |
| Total Medicare Payment Amount | 69558.59 |
| Total Medicare Standardized Payment Amount | 73466.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2363 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 3085.28 |
| Total Drug Medicare AllowedAmount | 916.2 |
| Total Drug Medicare PaymentAmount | 718.22 |
| Total Drug Medicare Standardized Payment Amount | 718.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 1475 |
| Number Of Medicare Beneficiaries With Medical Services | 1098 |
| Total Medical Submitted Charge Amount | 362701.4 |
| Total Medical Medicare Allowed Amount | 94458.51 |
| Total Medical Medicare Payment Amount | 68840.37 |
| Total Medical Medicare Standardized Payment Amount | 72747.92 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 370 |
| Number Of Beneficiaries Age 65 to 74 | 398 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 96 |
| Number Of Female Beneficiaries | 517 |
| Number Of Male Beneficiaries | 581 |
| Number Of Non Hispanic White Beneficiaries | 846 |
| Number Of Black or African American Beneficiaries | 216 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 729 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 369 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.4968 |