| National Provider Identifier [NPI]: | 1265416937 |
| Last Name Of The Provider | ALBOUCREK |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 W COMMERCIAL BLVD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | FORT LAUDERDALE |
| Zip Code Of The Provider | 333093073 |
| 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 | 175 |
| Number Of Services | 4676 |
| Number Of Medicare Beneficiaries | 2921 |
| Total Submitted Charge Amount | 594260 |
| Total Medicare Allowed Amount | 127655.65 |
| Total Medicare Payment Amount | 96324.7 |
| Total Medicare Standardized Payment Amount | 93174.2 |
| 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 | 175 |
| Number Of Medical Services | 4676 |
| Number Of Medicare Beneficiaries With Medical Services | 2921 |
| Total Medical Submitted Charge Amount | 594260 |
| Total Medical Medicare Allowed Amount | 127655.65 |
| Total Medical Medicare Payment Amount | 96324.7 |
| Total Medical Medicare Standardized Payment Amount | 93174.2 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 805 |
| Number Of Beneficiaries Age 65 to 74 | 967 |
| Number Of Beneficiaries Age 75 to 84 | 647 |
| Number Of Beneficiaries Age Greater 84 | 502 |
| Number Of Female Beneficiaries | 1548 |
| Number Of Male Beneficiaries | 1373 |
| Number Of Non Hispanic White Beneficiaries | 1883 |
| Number Of Black or African American Beneficiaries | 719 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 212 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 69 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1692 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1229 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 43 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1352 |