| National Provider Identifier [NPI]: | 1396776944 |
| Last Name Of The Provider | DANNEMANN |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1909 HONEYSUCKLE RD |
| Street Address 2 Of The Provider | SUITE 2 |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363054289 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 6135 |
| Number Of Medicare Beneficiaries | 1053 |
| Total Submitted Charge Amount | 787411 |
| Total Medicare Allowed Amount | 489265.68 |
| Total Medicare Payment Amount | 348684.06 |
| Total Medicare Standardized Payment Amount | 382148.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 52 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 3291 |
| Total Drug Medicare AllowedAmount | 2481.75 |
| Total Drug Medicare PaymentAmount | 1809 |
| Total Drug Medicare Standardized Payment Amount | 1809 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 6083 |
| Number Of Medicare Beneficiaries With Medical Services | 1053 |
| Total Medical Submitted Charge Amount | 784120 |
| Total Medical Medicare Allowed Amount | 486783.93 |
| Total Medical Medicare Payment Amount | 346875.06 |
| Total Medical Medicare Standardized Payment Amount | 380339.65 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 428 |
| Number Of Beneficiaries Age 75 to 84 | 361 |
| Number Of Beneficiaries Age Greater 84 | 148 |
| Number Of Female Beneficiaries | 657 |
| Number Of Male Beneficiaries | 396 |
| Number Of Non Hispanic White Beneficiaries | 776 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 835 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 218 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0295 |