| National Provider Identifier [NPI]: | 1801812854 |
| Last Name Of The Provider | MUMFORD |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4411 THE 25 WAY NE |
| Street Address 2 Of The Provider | SUITE 150 |
| City Of The Provider | ALBUQUERQUE |
| Zip Code Of The Provider | 871095857 |
| State Code Of The Provider | NM |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 3205 |
| Number Of Medicare Beneficiaries | 2330 |
| Total Submitted Charge Amount | 312054 |
| Total Medicare Allowed Amount | 95987.8 |
| Total Medicare Payment Amount | 73899.7 |
| Total Medicare Standardized Payment Amount | 76464.76 |
| 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 | 3205 |
| Number Of Medicare Beneficiaries With Medical Services | 2330 |
| Total Medical Submitted Charge Amount | 312054 |
| Total Medical Medicare Allowed Amount | 95987.8 |
| Total Medical Medicare Payment Amount | 73899.7 |
| Total Medical Medicare Standardized Payment Amount | 76464.76 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 560 |
| Number Of Beneficiaries Age 65 to 74 | 689 |
| Number Of Beneficiaries Age 75 to 84 | 657 |
| Number Of Beneficiaries Age Greater 84 | 424 |
| Number Of Female Beneficiaries | 1358 |
| Number Of Male Beneficiaries | 972 |
| Number Of Non Hispanic White Beneficiaries | 1316 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 789 |
| Number Of American Indian Alaska Native Beneficiaries | 123 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1492 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 838 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7021 |