| National Provider Identifier [NPI]: | 1811906118 |
| Last Name Of The Provider | MARINO |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8870 CEDAR SPRINGS LN |
| Street Address 2 Of The Provider | SUITE 106 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379235407 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 5904 |
| Number Of Medicare Beneficiaries | 3251 |
| Total Submitted Charge Amount | 313417 |
| Total Medicare Allowed Amount | 95242.52 |
| Total Medicare Payment Amount | 72494.96 |
| Total Medicare Standardized Payment Amount | 76154.55 |
| 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 | 123 |
| Number Of Medical Services | 5904 |
| Number Of Medicare Beneficiaries With Medical Services | 3251 |
| Total Medical Submitted Charge Amount | 313417 |
| Total Medical Medicare Allowed Amount | 95242.52 |
| Total Medical Medicare Payment Amount | 72494.96 |
| Total Medical Medicare Standardized Payment Amount | 76154.55 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 1311 |
| Number Of Beneficiaries Age 65 to 74 | 1134 |
| Number Of Beneficiaries Age 75 to 84 | 629 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 1856 |
| Number Of Male Beneficiaries | 1395 |
| Number Of Non Hispanic White Beneficiaries | 3198 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1494 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1757 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 43 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3135 |