| National Provider Identifier [NPI]: | 1104863612 |
| Last Name Of The Provider | DIENES |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 512 NOKOMIS AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342852817 |
| 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 | 78 |
| Number Of Services | 26387.5 |
| Number Of Medicare Beneficiaries | 2039 |
| Total Submitted Charge Amount | 589449.47 |
| Total Medicare Allowed Amount | 480629.72 |
| Total Medicare Payment Amount | 371475.95 |
| Total Medicare Standardized Payment Amount | 384910.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 23473.5 |
| Number Of Medicare Beneficiaries With Drug Services | 308 |
| Total Drug Submitted ChargeAmount | 48271 |
| Total Drug Medicare AllowedAmount | 9905.21 |
| Total Drug Medicare PaymentAmount | 7765.69 |
| Total Drug Medicare Standardized Payment Amount | 7765.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 2914 |
| Number Of Medicare Beneficiaries With Medical Services | 2039 |
| Total Medical Submitted Charge Amount | 541178.47 |
| Total Medical Medicare Allowed Amount | 470724.51 |
| Total Medical Medicare Payment Amount | 363710.26 |
| Total Medical Medicare Standardized Payment Amount | 377145.3 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 154 |
| Number Of Beneficiaries Age 65 to 74 | 819 |
| Number Of Beneficiaries Age 75 to 84 | 723 |
| Number Of Beneficiaries Age Greater 84 | 343 |
| Number Of Female Beneficiaries | 1207 |
| Number Of Male Beneficiaries | 832 |
| Number Of Non Hispanic White Beneficiaries | 1969 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1887 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 152 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.1885 |