| National Provider Identifier [NPI]: | 1558467431 |
| Last Name Of The Provider | BLACKBURN |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2868 MAHAN DR |
| Street Address 2 Of The Provider | SUITE 5 |
| City Of The Provider | TALLAHASSEE |
| Zip Code Of The Provider | 323085468 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 1907 |
| Number Of Medicare Beneficiaries | 457 |
| Total Submitted Charge Amount | 159833.75 |
| Total Medicare Allowed Amount | 109994.97 |
| Total Medicare Payment Amount | 80874.85 |
| Total Medicare Standardized Payment Amount | 81701.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 745 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 3708.75 |
| Total Drug Medicare AllowedAmount | 3708.75 |
| Total Drug Medicare PaymentAmount | 2906.57 |
| Total Drug Medicare Standardized Payment Amount | 2906.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1162 |
| Number Of Medicare Beneficiaries With Medical Services | 457 |
| Total Medical Submitted Charge Amount | 156125 |
| Total Medical Medicare Allowed Amount | 106286.22 |
| Total Medical Medicare Payment Amount | 77968.28 |
| Total Medical Medicare Standardized Payment Amount | 78795.22 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 164 |
| Number Of Beneficiaries Age 75 to 84 | 128 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 285 |
| Number Of Male Beneficiaries | 172 |
| Number Of Non Hispanic White Beneficiaries | 325 |
| Number Of Black or African American Beneficiaries | 117 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 326 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 1.6271 |