| National Provider Identifier [NPI]: | 1104911387 |
| Last Name Of The Provider | DEPRIEST |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1161 21ST AVE S |
| Street Address 2 Of The Provider | VUMC DEPT OF RADIOLOGY CCC-1106 MCN |
| City Of The Provider | NASHVILLE |
| Zip Code Of The Provider | 372320011 |
| 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 | 128 |
| Number Of Services | 24736 |
| Number Of Medicare Beneficiaries | 1158 |
| Total Submitted Charge Amount | 850750.5 |
| Total Medicare Allowed Amount | 198573.84 |
| Total Medicare Payment Amount | 149181.58 |
| Total Medicare Standardized Payment Amount | 167302.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 23119 |
| Number Of Medicare Beneficiaries With Drug Services | 274 |
| Total Drug Submitted ChargeAmount | 31000.5 |
| Total Drug Medicare AllowedAmount | 6744.61 |
| Total Drug Medicare PaymentAmount | 5191.73 |
| Total Drug Medicare Standardized Payment Amount | 5191.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 120 |
| Number Of Medical Services | 1617 |
| Number Of Medicare Beneficiaries With Medical Services | 1158 |
| Total Medical Submitted Charge Amount | 819750 |
| Total Medical Medicare Allowed Amount | 191829.23 |
| Total Medical Medicare Payment Amount | 143989.85 |
| Total Medical Medicare Standardized Payment Amount | 162110.81 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 251 |
| Number Of Beneficiaries Age 65 to 74 | 563 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 665 |
| Number Of Male Beneficiaries | 493 |
| Number Of Non Hispanic White Beneficiaries | 1040 |
| Number Of Black or African American Beneficiaries | 82 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 982 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 176 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.439 |