| National Provider Identifier [NPI]: | 1316978737 |
| Last Name Of The Provider | CANTWELL |
| First Name Of The Provider | TONY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 545 HEALTH BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321141493 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 7007 |
| Number Of Medicare Beneficiaries | 946 |
| Total Submitted Charge Amount | 1039051.46 |
| Total Medicare Allowed Amount | 343411.87 |
| Total Medicare Payment Amount | 259522.61 |
| Total Medicare Standardized Payment Amount | 261364.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 1858 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 224547.46 |
| Total Drug Medicare AllowedAmount | 54108.12 |
| Total Drug Medicare PaymentAmount | 42288.23 |
| Total Drug Medicare Standardized Payment Amount | 42288.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 5149 |
| Number Of Medicare Beneficiaries With Medical Services | 946 |
| Total Medical Submitted Charge Amount | 814504 |
| Total Medical Medicare Allowed Amount | 289303.75 |
| Total Medical Medicare Payment Amount | 217234.38 |
| Total Medical Medicare Standardized Payment Amount | 219076.12 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 77 |
| Number Of Beneficiaries Age 65 to 74 | 328 |
| Number Of Beneficiaries Age 75 to 84 | 347 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 269 |
| Number Of Male Beneficiaries | 677 |
| Number Of Non Hispanic White Beneficiaries | 855 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 819 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3005 |