| National Provider Identifier [NPI]: | 1144281437 |
| Last Name Of The Provider | DERAIMO |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5151 N 9TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PENSACOLA |
| Zip Code Of The Provider | 325048721 |
| 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 | 192 |
| Number Of Services | 7604 |
| Number Of Medicare Beneficiaries | 4928 |
| Total Submitted Charge Amount | 1072415.93 |
| Total Medicare Allowed Amount | 259885.4 |
| Total Medicare Payment Amount | 189770.22 |
| Total Medicare Standardized Payment Amount | 190843.67 |
| 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 | 192 |
| Number Of Medical Services | 7604 |
| Number Of Medicare Beneficiaries With Medical Services | 4928 |
| Total Medical Submitted Charge Amount | 1072415.93 |
| Total Medical Medicare Allowed Amount | 259885.4 |
| Total Medical Medicare Payment Amount | 189770.22 |
| Total Medical Medicare Standardized Payment Amount | 190843.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 976 |
| Number Of Beneficiaries Age 65 to 74 | 1789 |
| Number Of Beneficiaries Age 75 to 84 | 1473 |
| Number Of Beneficiaries Age Greater 84 | 690 |
| Number Of Female Beneficiaries | 2849 |
| Number Of Male Beneficiaries | 2079 |
| Number Of Non Hispanic White Beneficiaries | 4028 |
| Number Of Black or African American Beneficiaries | 695 |
| Number Of AsianPacific Islander Beneficiaries | 49 |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 62 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3675 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1253 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6123 |