| National Provider Identifier [NPI]: | 1619966520 |
| Last Name Of The Provider | CORNNELL |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 PASADENA AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH PASADENA |
| Zip Code Of The Provider | 337073717 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 6047 |
| Number Of Medicare Beneficiaries | 2682 |
| Total Submitted Charge Amount | 499450 |
| Total Medicare Allowed Amount | 197810.43 |
| Total Medicare Payment Amount | 148917.91 |
| Total Medicare Standardized Payment Amount | 148694.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 161 |
| Number Of Medical Services | 6047 |
| Number Of Medicare Beneficiaries With Medical Services | 2682 |
| Total Medical Submitted Charge Amount | 499450 |
| Total Medical Medicare Allowed Amount | 197810.43 |
| Total Medical Medicare Payment Amount | 148917.91 |
| Total Medical Medicare Standardized Payment Amount | 148694.98 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 224 |
| Number Of Beneficiaries Age 65 to 74 | 696 |
| Number Of Beneficiaries Age 75 to 84 | 881 |
| Number Of Beneficiaries Age Greater 84 | 881 |
| Number Of Female Beneficiaries | 1734 |
| Number Of Male Beneficiaries | 948 |
| Number Of Non Hispanic White Beneficiaries | 2517 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 21 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 423 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.557 |