| National Provider Identifier [NPI]: | 1851391536 |
| Last Name Of The Provider | VANBLARGAN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 549 FAIR ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLOOMSBURG |
| Zip Code Of The Provider | 178151419 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 3546 |
| Number Of Medicare Beneficiaries | 1669 |
| Total Submitted Charge Amount | 288200.5 |
| Total Medicare Allowed Amount | 88709.33 |
| Total Medicare Payment Amount | 68685.41 |
| Total Medicare Standardized Payment Amount | 70807.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 157 |
| Number Of Medical Services | 3546 |
| Number Of Medicare Beneficiaries With Medical Services | 1669 |
| Total Medical Submitted Charge Amount | 288200.5 |
| Total Medical Medicare Allowed Amount | 88709.33 |
| Total Medical Medicare Payment Amount | 68685.41 |
| Total Medical Medicare Standardized Payment Amount | 70807.09 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 347 |
| Number Of Beneficiaries Age 65 to 74 | 714 |
| Number Of Beneficiaries Age 75 to 84 | 386 |
| Number Of Beneficiaries Age Greater 84 | 222 |
| Number Of Female Beneficiaries | 1157 |
| Number Of Male Beneficiaries | 512 |
| Number Of Non Hispanic White Beneficiaries | 1615 |
| Number Of Black or African American Beneficiaries | 14 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1221 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 448 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2236 |