| National Provider Identifier [NPI]: | 1750381190 |
| Last Name Of The Provider | IMANUEL |
| First Name Of The Provider | HOWARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8851 BOARDROOM CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339194888 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 7326 |
| Number Of Medicare Beneficiaries | 377 |
| Total Submitted Charge Amount | 881945.72 |
| Total Medicare Allowed Amount | 551963.06 |
| Total Medicare Payment Amount | 418730.18 |
| Total Medicare Standardized Payment Amount | 393736.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 410 |
| Number Of Medicare Beneficiaries With Drug Services | 109 |
| Total Drug Submitted ChargeAmount | 1051.22 |
| Total Drug Medicare AllowedAmount | 512.35 |
| Total Drug Medicare PaymentAmount | 401.69 |
| Total Drug Medicare Standardized Payment Amount | 401.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 6916 |
| Number Of Medicare Beneficiaries With Medical Services | 377 |
| Total Medical Submitted Charge Amount | 880894.5 |
| Total Medical Medicare Allowed Amount | 551450.71 |
| Total Medical Medicare Payment Amount | 418328.49 |
| Total Medical Medicare Standardized Payment Amount | 393334.4 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | 146 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 210 |
| Number Of Male Beneficiaries | 167 |
| Number Of Non Hispanic White Beneficiaries | 358 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 363 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4449 |