| National Provider Identifier [NPI]: | 1730152208 |
| Last Name Of The Provider | ERDMAN |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1661 SOQUEL DRIVE |
| Street Address 2 Of The Provider | BUILDING G |
| City Of The Provider | SANTA CRUZ |
| Zip Code Of The Provider | 95065 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 7836 |
| Number Of Medicare Beneficiaries | 2155 |
| Total Submitted Charge Amount | 564219.8 |
| Total Medicare Allowed Amount | 164640.97 |
| Total Medicare Payment Amount | 125440.86 |
| Total Medicare Standardized Payment Amount | 122500.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 4504 |
| Number Of Medicare Beneficiaries With Drug Services | 58 |
| Total Drug Submitted ChargeAmount | 4673.8 |
| Total Drug Medicare AllowedAmount | 1257.35 |
| Total Drug Medicare PaymentAmount | 984.32 |
| Total Drug Medicare Standardized Payment Amount | 984.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 162 |
| Number Of Medical Services | 3332 |
| Number Of Medicare Beneficiaries With Medical Services | 2155 |
| Total Medical Submitted Charge Amount | 559546 |
| Total Medical Medicare Allowed Amount | 163383.62 |
| Total Medical Medicare Payment Amount | 124456.54 |
| Total Medical Medicare Standardized Payment Amount | 121515.83 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 375 |
| Number Of Beneficiaries Age 65 to 74 | 769 |
| Number Of Beneficiaries Age 75 to 84 | 533 |
| Number Of Beneficiaries Age Greater 84 | 478 |
| Number Of Female Beneficiaries | 1201 |
| Number Of Male Beneficiaries | 954 |
| Number Of Non Hispanic White Beneficiaries | 1606 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 50 |
| Number Of Hispanic Beneficiaries | 447 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1461 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 694 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5672 |