| National Provider Identifier [NPI]: | 1922004597 |
| Last Name Of The Provider | EVANCHO |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1112 E WEISGARBER RD |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379092647 |
| 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 | 192 |
| Number Of Services | 5516 |
| Number Of Medicare Beneficiaries | 2625 |
| Total Submitted Charge Amount | 486358.86 |
| Total Medicare Allowed Amount | 147193.63 |
| Total Medicare Payment Amount | 117462.61 |
| Total Medicare Standardized Payment Amount | 127055.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1492 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 2116.9 |
| Total Drug Medicare AllowedAmount | 656.02 |
| Total Drug Medicare PaymentAmount | 514.31 |
| Total Drug Medicare Standardized Payment Amount | 514.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 188 |
| Number Of Medical Services | 4024 |
| Number Of Medicare Beneficiaries With Medical Services | 2625 |
| Total Medical Submitted Charge Amount | 484241.96 |
| Total Medical Medicare Allowed Amount | 146537.61 |
| Total Medical Medicare Payment Amount | 116948.3 |
| Total Medical Medicare Standardized Payment Amount | 126541.58 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 548 |
| Number Of Beneficiaries Age 65 to 74 | 1034 |
| Number Of Beneficiaries Age 75 to 84 | 717 |
| Number Of Beneficiaries Age Greater 84 | 326 |
| Number Of Female Beneficiaries | 1740 |
| Number Of Male Beneficiaries | 885 |
| Number Of Non Hispanic White Beneficiaries | 2468 |
| Number Of Black or African American Beneficiaries | 112 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1897 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 728 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4271 |