| National Provider Identifier [NPI]: | 1245279975 |
| Last Name Of The Provider | MUNGOVAN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 363 HIGHLAND AVE |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | FALL RIVER |
| Zip Code Of The Provider | 027203703 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 210 |
| Number Of Services | 6758 |
| Number Of Medicare Beneficiaries | 3962 |
| Total Submitted Charge Amount | 558912 |
| Total Medicare Allowed Amount | 192166.08 |
| Total Medicare Payment Amount | 143930.66 |
| Total Medicare Standardized Payment Amount | 143078.56 |
| 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 | 210 |
| Number Of Medical Services | 6758 |
| Number Of Medicare Beneficiaries With Medical Services | 3962 |
| Total Medical Submitted Charge Amount | 558912 |
| Total Medical Medicare Allowed Amount | 192166.08 |
| Total Medical Medicare Payment Amount | 143930.66 |
| Total Medical Medicare Standardized Payment Amount | 143078.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 847 |
| Number Of Beneficiaries Age 65 to 74 | 1347 |
| Number Of Beneficiaries Age 75 to 84 | 1024 |
| Number Of Beneficiaries Age Greater 84 | 744 |
| Number Of Female Beneficiaries | 2423 |
| Number Of Male Beneficiaries | 1539 |
| Number Of Non Hispanic White Beneficiaries | 3632 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 191 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2616 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1346 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.616 |