| National Provider Identifier [NPI]: | 1760467914 |
| Last Name Of The Provider | KOCHANSKI |
| First Name Of The Provider | SANDRA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 620 CROSSOVER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUPELO |
| Zip Code Of The Provider | 388014944 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 116 |
| Number Of Services | 9473 |
| Number Of Medicare Beneficiaries | 4336 |
| Total Submitted Charge Amount | 628144 |
| Total Medicare Allowed Amount | 188561.91 |
| Total Medicare Payment Amount | 141070.2 |
| Total Medicare Standardized Payment Amount | 151256.84 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1286 |
| Number Of Beneficiaries Age 65 to 74 | 1296 |
| Number Of Beneficiaries Age 75 to 84 | 1120 |
| Number Of Beneficiaries Age Greater 84 | 634 |
| Number Of Female Beneficiaries | 2502 |
| Number Of Male Beneficiaries | 1834 |
| Number Of Non Hispanic White Beneficiaries | 3345 |
| Number Of Black or African American Beneficiaries | 948 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2222 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2114 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.7528 |