| National Provider Identifier [NPI]: | 1558318964 |
| Last Name Of The Provider | TERRY |
| First Name Of The Provider | NINA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 19TH STREET SOUTH |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 35233 |
| 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 | 77 |
| Number Of Services | 11387 |
| Number Of Medicare Beneficiaries | 3787 |
| Total Submitted Charge Amount | 655365 |
| Total Medicare Allowed Amount | 109520.66 |
| Total Medicare Payment Amount | 80112.22 |
| Total Medicare Standardized Payment Amount | 90159.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 4382 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 4382 |
| Total Drug Medicare AllowedAmount | 757.29 |
| Total Drug Medicare PaymentAmount | 524.38 |
| Total Drug Medicare Standardized Payment Amount | 524.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 7005 |
| Number Of Medicare Beneficiaries With Medical Services | 3787 |
| Total Medical Submitted Charge Amount | 650983 |
| Total Medical Medicare Allowed Amount | 108763.37 |
| Total Medical Medicare Payment Amount | 79587.84 |
| Total Medical Medicare Standardized Payment Amount | 89635.03 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 1260 |
| Number Of Beneficiaries Age 65 to 74 | 1392 |
| Number Of Beneficiaries Age 75 to 84 | 849 |
| Number Of Beneficiaries Age Greater 84 | 286 |
| Number Of Female Beneficiaries | 1893 |
| Number Of Male Beneficiaries | 1894 |
| Number Of Non Hispanic White Beneficiaries | 2676 |
| Number Of Black or African American Beneficiaries | 1034 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2803 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 984 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 55 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.2986 |