| National Provider Identifier [NPI]: | 1104817287 |
| Last Name Of The Provider | BANCROFT |
| First Name Of The Provider | LAURA |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 601 E. ROLLINS STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 32803 |
| 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 | 98 |
| Number Of Services | 4120 |
| Number Of Medicare Beneficiaries | 2516 |
| Total Submitted Charge Amount | 281726.31 |
| Total Medicare Allowed Amount | 95290.6 |
| Total Medicare Payment Amount | 74244.86 |
| Total Medicare Standardized Payment Amount | 75243.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 945 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 571.38 |
| Total Drug Medicare AllowedAmount | 308.15 |
| Total Drug Medicare PaymentAmount | 241.6 |
| Total Drug Medicare Standardized Payment Amount | 241.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 3175 |
| Number Of Medicare Beneficiaries With Medical Services | 2514 |
| Total Medical Submitted Charge Amount | 281154.93 |
| Total Medical Medicare Allowed Amount | 94982.45 |
| Total Medical Medicare Payment Amount | 74003.26 |
| Total Medical Medicare Standardized Payment Amount | 75001.74 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 363 |
| Number Of Beneficiaries Age 65 to 74 | 1014 |
| Number Of Beneficiaries Age 75 to 84 | 743 |
| Number Of Beneficiaries Age Greater 84 | 396 |
| Number Of Female Beneficiaries | 1728 |
| Number Of Male Beneficiaries | 788 |
| Number Of Non Hispanic White Beneficiaries | 1911 |
| Number Of Black or African American Beneficiaries | 224 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 291 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 44 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1951 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 565 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 58 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7764 |