| National Provider Identifier [NPI]: | 1396741070 |
| Last Name Of The Provider | EBERENZ |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1112 E WEISGARBER RD |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | KNOXVILLE |
| Zip Code Of The Provider | 379092647 |
| 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 | 215 |
| Number Of Services | 6459 |
| Number Of Medicare Beneficiaries | 2627 |
| Total Submitted Charge Amount | 623691.87 |
| Total Medicare Allowed Amount | 179070.63 |
| Total Medicare Payment Amount | 139837.54 |
| Total Medicare Standardized Payment Amount | 152161.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2582 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 3427.7 |
| Total Drug Medicare AllowedAmount | 924.35 |
| Total Drug Medicare PaymentAmount | 724.67 |
| Total Drug Medicare Standardized Payment Amount | 724.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 211 |
| Number Of Medical Services | 3877 |
| Number Of Medicare Beneficiaries With Medical Services | 2627 |
| Total Medical Submitted Charge Amount | 620264.17 |
| Total Medical Medicare Allowed Amount | 178146.28 |
| Total Medical Medicare Payment Amount | 139112.87 |
| Total Medical Medicare Standardized Payment Amount | 151436.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 592 |
| Number Of Beneficiaries Age 65 to 74 | 988 |
| Number Of Beneficiaries Age 75 to 84 | 682 |
| Number Of Beneficiaries Age Greater 84 | 365 |
| Number Of Female Beneficiaries | 1583 |
| Number Of Male Beneficiaries | 1044 |
| Number Of Non Hispanic White Beneficiaries | 2471 |
| Number Of Black or African American Beneficiaries | 116 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1825 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 802 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5409 |