| National Provider Identifier [NPI]: | 1336147354 |
| Last Name Of The Provider | DANNENBAUM |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 CARNIE BLVD |
| Street Address 2 Of The Provider | SUITE B-5 |
| City Of The Provider | VOORHEES |
| Zip Code Of The Provider | 080434512 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 6894.4 |
| Number Of Medicare Beneficiaries | 4490 |
| Total Submitted Charge Amount | 1214813.42 |
| Total Medicare Allowed Amount | 319946.76 |
| Total Medicare Payment Amount | 244946.48 |
| Total Medicare Standardized Payment Amount | 228650.86 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 659 |
| Number Of Beneficiaries Age 65 to 74 | 1609 |
| Number Of Beneficiaries Age 75 to 84 | 1303 |
| Number Of Beneficiaries Age Greater 84 | 919 |
| Number Of Female Beneficiaries | 2828 |
| Number Of Male Beneficiaries | 1662 |
| Number Of Non Hispanic White Beneficiaries | 3692 |
| Number Of Black or African American Beneficiaries | 487 |
| Number Of AsianPacific Islander Beneficiaries | 98 |
| Number Of Hispanic Beneficiaries | 144 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3746 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 744 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6968 |