| National Provider Identifier [NPI]: | 1174574180 |
| Last Name Of The Provider | DANN |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | A |
| 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 | 87 |
| Number Of Services | 5511 |
| Number Of Medicare Beneficiaries | 966 |
| Total Submitted Charge Amount | 915629.38 |
| Total Medicare Allowed Amount | 324201.89 |
| Total Medicare Payment Amount | 243978.26 |
| Total Medicare Standardized Payment Amount | 245098.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1036 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 153947.38 |
| Total Drug Medicare AllowedAmount | 33159.97 |
| Total Drug Medicare PaymentAmount | 25873.38 |
| Total Drug Medicare Standardized Payment Amount | 25873.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 4475 |
| Number Of Medicare Beneficiaries With Medical Services | 966 |
| Total Medical Submitted Charge Amount | 761682 |
| Total Medical Medicare Allowed Amount | 291041.92 |
| Total Medical Medicare Payment Amount | 218104.88 |
| Total Medical Medicare Standardized Payment Amount | 219225.11 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 440 |
| Number Of Beneficiaries Age 75 to 84 | 337 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 792 |
| Number Of Non Hispanic White Beneficiaries | 804 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 54 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 881 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2217 |