| National Provider Identifier [NPI]: | 1982608782 |
| Last Name Of The Provider | DANNEBERGER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 RIDGELY AVE STE 222 |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANNAPOLIS |
| Zip Code Of The Provider | 214011073 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 9700 |
| Number Of Medicare Beneficiaries | 1758 |
| Total Submitted Charge Amount | 1083318 |
| Total Medicare Allowed Amount | 506604.22 |
| Total Medicare Payment Amount | 379639.7 |
| Total Medicare Standardized Payment Amount | 364031.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2403 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 289345 |
| Total Drug Medicare AllowedAmount | 116191.15 |
| Total Drug Medicare PaymentAmount | 90827.12 |
| Total Drug Medicare Standardized Payment Amount | 90827.12 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 7297 |
| Number Of Medicare Beneficiaries With Medical Services | 1758 |
| Total Medical Submitted Charge Amount | 793973 |
| Total Medical Medicare Allowed Amount | 390413.07 |
| Total Medical Medicare Payment Amount | 288812.58 |
| Total Medical Medicare Standardized Payment Amount | 273204.35 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 758 |
| Number Of Beneficiaries Age 75 to 84 | 652 |
| Number Of Beneficiaries Age Greater 84 | 273 |
| Number Of Female Beneficiaries | 518 |
| Number Of Male Beneficiaries | 1240 |
| Number Of Non Hispanic White Beneficiaries | 1578 |
| Number Of Black or African American Beneficiaries | 142 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1693 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1456 |