| National Provider Identifier [NPI]: | 1710203732 |
| Last Name Of The Provider | FEUERLEIN |
| First Name Of The Provider | KARL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | LEE ST FL 1 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTESVILLE |
| Zip Code Of The Provider | 229080001 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 15561 |
| Number Of Medicare Beneficiaries | 2086 |
| Total Submitted Charge Amount | 2769424.4 |
| Total Medicare Allowed Amount | 339565.43 |
| Total Medicare Payment Amount | 255290.18 |
| Total Medicare Standardized Payment Amount | 266288.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 12012 |
| Number Of Medicare Beneficiaries With Drug Services | 329 |
| Total Drug Submitted ChargeAmount | 42552.4 |
| Total Drug Medicare AllowedAmount | 5950.64 |
| Total Drug Medicare PaymentAmount | 4663.89 |
| Total Drug Medicare Standardized Payment Amount | 4663.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 3549 |
| Number Of Medicare Beneficiaries With Medical Services | 2086 |
| Total Medical Submitted Charge Amount | 2726872 |
| Total Medical Medicare Allowed Amount | 333614.79 |
| Total Medical Medicare Payment Amount | 250626.29 |
| Total Medical Medicare Standardized Payment Amount | 261624.33 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 487 |
| Number Of Beneficiaries Age 65 to 74 | 897 |
| Number Of Beneficiaries Age 75 to 84 | 518 |
| Number Of Beneficiaries Age Greater 84 | 184 |
| Number Of Female Beneficiaries | 1078 |
| Number Of Male Beneficiaries | 1008 |
| Number Of Non Hispanic White Beneficiaries | 1682 |
| Number Of Black or African American Beneficiaries | 335 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9565 |