| National Provider Identifier [NPI]: | 1255403853 |
| Last Name Of The Provider | HOAG |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20715 E OCOTILLO RD |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | QUEEN CREEK |
| Zip Code Of The Provider | 851426118 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1740 |
| Number Of Medicare Beneficiaries | 347 |
| Total Submitted Charge Amount | 211393.56 |
| Total Medicare Allowed Amount | 137934.5 |
| Total Medicare Payment Amount | 97492.05 |
| Total Medicare Standardized Payment Amount | 101218.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 79 |
| Total Drug Submitted ChargeAmount | 7139.18 |
| Total Drug Medicare AllowedAmount | 2381.56 |
| Total Drug Medicare PaymentAmount | 2243.83 |
| Total Drug Medicare Standardized Payment Amount | 2243.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 1586 |
| Number Of Medicare Beneficiaries With Medical Services | 347 |
| Total Medical Submitted Charge Amount | 204254.38 |
| Total Medical Medicare Allowed Amount | 135552.94 |
| Total Medical Medicare Payment Amount | 95248.22 |
| Total Medical Medicare Standardized Payment Amount | 98974.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 207 |
| Number Of Beneficiaries Age 75 to 84 | 85 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 190 |
| Number Of Male Beneficiaries | 157 |
| Number Of Non Hispanic White Beneficiaries | 318 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9407 |