| National Provider Identifier [NPI]: | 1740213503 |
| Last Name Of The Provider | DJURISIC |
| First Name Of The Provider | TAMARA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11000 N SCOTTSDALE RD |
| Street Address 2 Of The Provider | STE 120 |
| City Of The Provider | SCOTTSDALE |
| Zip Code Of The Provider | 852546130 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 272 |
| Number Of Medicare Beneficiaries | 101 |
| Total Submitted Charge Amount | 36989.78 |
| Total Medicare Allowed Amount | 19592.55 |
| Total Medicare Payment Amount | 14461.61 |
| Total Medicare Standardized Payment Amount | 14580.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 399.7 |
| Total Drug Medicare AllowedAmount | 232.99 |
| Total Drug Medicare PaymentAmount | 223.55 |
| Total Drug Medicare Standardized Payment Amount | 223.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 245 |
| Number Of Medicare Beneficiaries With Medical Services | 101 |
| Total Medical Submitted Charge Amount | 36590.08 |
| Total Medical Medicare Allowed Amount | 19359.56 |
| Total Medical Medicare Payment Amount | 14238.06 |
| Total Medical Medicare Standardized Payment Amount | 14357.16 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 39 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 45 |
| Number Of Male Beneficiaries | 56 |
| Number Of Non Hispanic White Beneficiaries | 66 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 73 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0443 |