| National Provider Identifier [NPI]: | 1558339580 |
| Last Name Of The Provider | VENNOS |
| First Name Of The Provider | ALEXANDER |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 SE TIFFANY AVE |
| Street Address 2 Of The Provider | ATTENTION RHONDA ROBERTSON RADIOLOGY DEPT |
| City Of The Provider | PORT ST LUCIE |
| Zip Code Of The Provider | 349527521 |
| 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 | 250 |
| Number Of Services | 14785 |
| Number Of Medicare Beneficiaries | 6104 |
| Total Submitted Charge Amount | 2666589 |
| Total Medicare Allowed Amount | 424865.32 |
| Total Medicare Payment Amount | 322016.97 |
| Total Medicare Standardized Payment Amount | 316837.99 |
| 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 | 250 |
| Number Of Medical Services | 14785 |
| Number Of Medicare Beneficiaries With Medical Services | 6104 |
| Total Medical Submitted Charge Amount | 2666589 |
| Total Medical Medicare Allowed Amount | 424865.32 |
| Total Medical Medicare Payment Amount | 322016.97 |
| Total Medical Medicare Standardized Payment Amount | 316837.99 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1069 |
| Number Of Beneficiaries Age 65 to 74 | 2151 |
| Number Of Beneficiaries Age 75 to 84 | 1873 |
| Number Of Beneficiaries Age Greater 84 | 1011 |
| Number Of Female Beneficiaries | 3579 |
| Number Of Male Beneficiaries | 2525 |
| Number Of Non Hispanic White Beneficiaries | 5129 |
| Number Of Black or African American Beneficiaries | 548 |
| Number Of AsianPacific Islander Beneficiaries | 24 |
| Number Of Hispanic Beneficiaries | 322 |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4385 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1719 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8157 |