| National Provider Identifier [NPI]: | 1730110255 |
| Last Name Of The Provider | PLEMONS |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11 UPPER RIVERDALE ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIVERDALE |
| Zip Code Of The Provider | 30274 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 163 |
| Number Of Services | 2487 |
| Number Of Medicare Beneficiaries | 1538 |
| Total Submitted Charge Amount | 406223 |
| Total Medicare Allowed Amount | 82941.24 |
| Total Medicare Payment Amount | 63445.34 |
| Total Medicare Standardized Payment Amount | 64244.8 |
| 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 | 163 |
| Number Of Medical Services | 2487 |
| Number Of Medicare Beneficiaries With Medical Services | 1538 |
| Total Medical Submitted Charge Amount | 406223 |
| Total Medical Medicare Allowed Amount | 82941.24 |
| Total Medical Medicare Payment Amount | 63445.34 |
| Total Medical Medicare Standardized Payment Amount | 64244.8 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 466 |
| Number Of Beneficiaries Age 65 to 74 | 591 |
| Number Of Beneficiaries Age 75 to 84 | 343 |
| Number Of Beneficiaries Age Greater 84 | 138 |
| Number Of Female Beneficiaries | 1004 |
| Number Of Male Beneficiaries | 534 |
| Number Of Non Hispanic White Beneficiaries | 565 |
| Number Of Black or African American Beneficiaries | 848 |
| Number Of AsianPacific Islander Beneficiaries | 65 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 923 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 615 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.0602 |