| National Provider Identifier [NPI]: | 1134165509 |
| Last Name Of The Provider | NOVINSKI |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2620 W FAIDLEY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND ISLAND |
| Zip Code Of The Provider | 688034205 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 184 |
| Number Of Services | 8298 |
| Number Of Medicare Beneficiaries | 4307 |
| Total Submitted Charge Amount | 820779 |
| Total Medicare Allowed Amount | 225985.22 |
| Total Medicare Payment Amount | 181629.14 |
| Total Medicare Standardized Payment Amount | 193940.31 |
| 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 | 184 |
| Number Of Medical Services | 8298 |
| Number Of Medicare Beneficiaries With Medical Services | 4307 |
| Total Medical Submitted Charge Amount | 820779 |
| Total Medical Medicare Allowed Amount | 225985.22 |
| Total Medical Medicare Payment Amount | 181629.14 |
| Total Medical Medicare Standardized Payment Amount | 193940.31 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 505 |
| Number Of Beneficiaries Age 65 to 74 | 1754 |
| Number Of Beneficiaries Age 75 to 84 | 1387 |
| Number Of Beneficiaries Age Greater 84 | 661 |
| Number Of Female Beneficiaries | 3254 |
| Number Of Male Beneficiaries | 1053 |
| Number Of Non Hispanic White Beneficiaries | 4150 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 101 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 27 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 783 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2339 |