| National Provider Identifier [NPI]: | 1891749008 |
| Last Name Of The Provider | DANEHY |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3680 BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339018005 |
| 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 | 149 |
| Number Of Services | 94846 |
| Number Of Medicare Beneficiaries | 3078 |
| Total Submitted Charge Amount | 3882240.94 |
| Total Medicare Allowed Amount | 835681.28 |
| Total Medicare Payment Amount | 644445.98 |
| Total Medicare Standardized Payment Amount | 623088.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 91063 |
| Number Of Medicare Beneficiaries With Drug Services | 1070 |
| Total Drug Submitted ChargeAmount | 143266.5 |
| Total Drug Medicare AllowedAmount | 26596.9 |
| Total Drug Medicare PaymentAmount | 20802.62 |
| Total Drug Medicare Standardized Payment Amount | 20802.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 3783 |
| Number Of Medicare Beneficiaries With Medical Services | 3065 |
| Total Medical Submitted Charge Amount | 3738974.44 |
| Total Medical Medicare Allowed Amount | 809084.38 |
| Total Medical Medicare Payment Amount | 623643.36 |
| Total Medical Medicare Standardized Payment Amount | 602286.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 314 |
| Number Of Beneficiaries Age 65 to 74 | 1472 |
| Number Of Beneficiaries Age 75 to 84 | 999 |
| Number Of Beneficiaries Age Greater 84 | 293 |
| Number Of Female Beneficiaries | 1747 |
| Number Of Male Beneficiaries | 1331 |
| Number Of Non Hispanic White Beneficiaries | 2691 |
| Number Of Black or African American Beneficiaries | 97 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 238 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2710 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 368 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2404 |