| National Provider Identifier [NPI]: | 1497720858 |
| Last Name Of The Provider | ENGELMAN |
| First Name Of The Provider | ELAINE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4516 N ARMENIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336032732 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 180 |
| Number Of Services | 18610 |
| Number Of Medicare Beneficiaries | 2871 |
| Total Submitted Charge Amount | 1116886.75 |
| Total Medicare Allowed Amount | 296539.54 |
| Total Medicare Payment Amount | 225792.04 |
| Total Medicare Standardized Payment Amount | 231796.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 14682 |
| Number Of Medicare Beneficiaries With Drug Services | 157 |
| Total Drug Submitted ChargeAmount | 38847.76 |
| Total Drug Medicare AllowedAmount | 3252.57 |
| Total Drug Medicare PaymentAmount | 2458.73 |
| Total Drug Medicare Standardized Payment Amount | 2458.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 3928 |
| Number Of Medicare Beneficiaries With Medical Services | 2869 |
| Total Medical Submitted Charge Amount | 1078038.99 |
| Total Medical Medicare Allowed Amount | 293286.97 |
| Total Medical Medicare Payment Amount | 223333.31 |
| Total Medical Medicare Standardized Payment Amount | 229337.42 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 497 |
| Number Of Beneficiaries Age 65 to 74 | 961 |
| Number Of Beneficiaries Age 75 to 84 | 826 |
| Number Of Beneficiaries Age Greater 84 | 587 |
| Number Of Female Beneficiaries | 1692 |
| Number Of Male Beneficiaries | 1179 |
| Number Of Non Hispanic White Beneficiaries | 1908 |
| Number Of Black or African American Beneficiaries | 332 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 573 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1918 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 953 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9833 |