| National Provider Identifier [NPI]: | 1306838529 |
| Last Name Of The Provider | KONIVER |
| First Name Of The Provider | GARTH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1701 AUGUSTINE CUT OFF |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILMINGTON |
| Zip Code Of The Provider | 198034415 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 18866 |
| Number Of Medicare Beneficiaries | 10494 |
| Total Submitted Charge Amount | 2777299 |
| Total Medicare Allowed Amount | 933526.67 |
| Total Medicare Payment Amount | 745127.7 |
| Total Medicare Standardized Payment Amount | 728201.57 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
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| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 1032 |
| Number Of Beneficiaries Age 65 to 74 | 5272 |
| Number Of Beneficiaries Age 75 to 84 | 3125 |
| Number Of Beneficiaries Age Greater 84 | 1065 |
| Number Of Female Beneficiaries | 7184 |
| Number Of Male Beneficiaries | 3310 |
| Number Of Non Hispanic White Beneficiaries | 8745 |
| Number Of Black or African American Beneficiaries | 1206 |
| Number Of AsianPacific Islander Beneficiaries | 190 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 195 |
| Number Of Beneficiaries With Medicare Only Entitlement | 9525 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 969 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.013 |