| National Provider Identifier [NPI]: | 1952399800 |
| Last Name Of The Provider | BENNETT |
| First Name Of The Provider | D |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 HAWKINS DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | IOWA CITY |
| Zip Code Of The Provider | 522421009 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 102 |
| Number Of Services | 3777 |
| Number Of Medicare Beneficiaries | 1978 |
| Total Submitted Charge Amount | 374324.4 |
| Total Medicare Allowed Amount | 68893.06 |
| Total Medicare Payment Amount | 50481.94 |
| Total Medicare Standardized Payment Amount | 54482.05 |
| 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 | 102 |
| Number Of Medical Services | 3777 |
| Number Of Medicare Beneficiaries With Medical Services | 1978 |
| Total Medical Submitted Charge Amount | 374324.4 |
| Total Medical Medicare Allowed Amount | 68893.06 |
| Total Medical Medicare Payment Amount | 50481.94 |
| Total Medical Medicare Standardized Payment Amount | 54482.05 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 532 |
| Number Of Beneficiaries Age 65 to 74 | 780 |
| Number Of Beneficiaries Age 75 to 84 | 472 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 1146 |
| Number Of Male Beneficiaries | 832 |
| Number Of Non Hispanic White Beneficiaries | 1844 |
| Number Of Black or African American Beneficiaries | 63 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 569 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.505 |