| National Provider Identifier [NPI]: | 1659376721 |
| Last Name Of The Provider | NICHOLSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 MEDICAL PARK DR E |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352353401 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 167 |
| Number Of Services | 2828 |
| Number Of Medicare Beneficiaries | 1466 |
| Total Submitted Charge Amount | 534568 |
| Total Medicare Allowed Amount | 127064.05 |
| Total Medicare Payment Amount | 100008.49 |
| Total Medicare Standardized Payment Amount | 108381.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 360 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1260 |
| Total Drug Medicare AllowedAmount | 713.13 |
| Total Drug Medicare PaymentAmount | 535.31 |
| Total Drug Medicare Standardized Payment Amount | 535.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 166 |
| Number Of Medical Services | 2468 |
| Number Of Medicare Beneficiaries With Medical Services | 1466 |
| Total Medical Submitted Charge Amount | 533308 |
| Total Medical Medicare Allowed Amount | 126350.92 |
| Total Medical Medicare Payment Amount | 99473.18 |
| Total Medical Medicare Standardized Payment Amount | 107846.64 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 272 |
| Number Of Beneficiaries Age 65 to 74 | 582 |
| Number Of Beneficiaries Age 75 to 84 | 442 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 974 |
| Number Of Male Beneficiaries | 492 |
| Number Of Non Hispanic White Beneficiaries | 1443 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1094 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 372 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3685 |