| National Provider Identifier [NPI]: | 1710932017 |
| Last Name Of The Provider | HIMMELFARB |
| First Name Of The Provider | ELLIOT |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3024 BUSINESS PARK CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | GOODLETTSVILLE |
| Zip Code Of The Provider | 370723132 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 185 |
| Number Of Services | 4683 |
| Number Of Medicare Beneficiaries | 2897 |
| Total Submitted Charge Amount | 701224.53 |
| Total Medicare Allowed Amount | 153606.65 |
| Total Medicare Payment Amount | 117539.94 |
| Total Medicare Standardized Payment Amount | 127045.22 |
| 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 | 185 |
| Number Of Medical Services | 4683 |
| Number Of Medicare Beneficiaries With Medical Services | 2897 |
| Total Medical Submitted Charge Amount | 701224.53 |
| Total Medical Medicare Allowed Amount | 153606.65 |
| Total Medical Medicare Payment Amount | 117539.94 |
| Total Medical Medicare Standardized Payment Amount | 127045.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 390 |
| Number Of Beneficiaries Age 65 to 74 | 1167 |
| Number Of Beneficiaries Age 75 to 84 | 844 |
| Number Of Beneficiaries Age Greater 84 | 496 |
| Number Of Female Beneficiaries | 1806 |
| Number Of Male Beneficiaries | 1091 |
| Number Of Non Hispanic White Beneficiaries | 2641 |
| Number Of Black or African American Beneficiaries | 197 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2510 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 387 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.446 |