| National Provider Identifier [NPI]: | 1184620692 |
| Last Name Of The Provider | NANNI |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 613 OAKFIELD DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRANDON |
| Zip Code Of The Provider | 335115714 |
| 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 | 177 |
| Number Of Services | 9947 |
| Number Of Medicare Beneficiaries | 2274 |
| Total Submitted Charge Amount | 797202.42 |
| Total Medicare Allowed Amount | 218590.45 |
| Total Medicare Payment Amount | 169943.2 |
| Total Medicare Standardized Payment Amount | 174430.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 6495 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 10002.27 |
| Total Drug Medicare AllowedAmount | 1715.04 |
| Total Drug Medicare PaymentAmount | 1333.98 |
| Total Drug Medicare Standardized Payment Amount | 1333.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 3452 |
| Number Of Medicare Beneficiaries With Medical Services | 2245 |
| Total Medical Submitted Charge Amount | 787200.15 |
| Total Medical Medicare Allowed Amount | 216875.41 |
| Total Medical Medicare Payment Amount | 168609.22 |
| Total Medical Medicare Standardized Payment Amount | 173096.74 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 370 |
| Number Of Beneficiaries Age 65 to 74 | 850 |
| Number Of Beneficiaries Age 75 to 84 | 699 |
| Number Of Beneficiaries Age Greater 84 | 355 |
| Number Of Female Beneficiaries | 1407 |
| Number Of Male Beneficiaries | 867 |
| Number Of Non Hispanic White Beneficiaries | 1761 |
| Number Of Black or African American Beneficiaries | 230 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 229 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1656 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 618 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8934 |