| National Provider Identifier [NPI]: | 1982675112 |
| Last Name Of The Provider | MCMANIMON |
| First Name Of The Provider | SHAUN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 677 N WILMOT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 857112701 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 197 |
| Number Of Services | 32419 |
| Number Of Medicare Beneficiaries | 2400 |
| Total Submitted Charge Amount | 936492.5 |
| Total Medicare Allowed Amount | 323048.47 |
| Total Medicare Payment Amount | 243001.3 |
| Total Medicare Standardized Payment Amount | 247042.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 29119 |
| Number Of Medicare Beneficiaries With Drug Services | 304 |
| Total Drug Submitted ChargeAmount | 30116.5 |
| Total Drug Medicare AllowedAmount | 5719.94 |
| Total Drug Medicare PaymentAmount | 4469.02 |
| Total Drug Medicare Standardized Payment Amount | 4469.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 193 |
| Number Of Medical Services | 3300 |
| Number Of Medicare Beneficiaries With Medical Services | 2399 |
| Total Medical Submitted Charge Amount | 906376 |
| Total Medical Medicare Allowed Amount | 317328.53 |
| Total Medical Medicare Payment Amount | 238532.28 |
| Total Medical Medicare Standardized Payment Amount | 242573.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 257 |
| Number Of Beneficiaries Age 65 to 74 | 950 |
| Number Of Beneficiaries Age 75 to 84 | 779 |
| Number Of Beneficiaries Age Greater 84 | 414 |
| Number Of Female Beneficiaries | 1363 |
| Number Of Male Beneficiaries | 1037 |
| Number Of Non Hispanic White Beneficiaries | 2069 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 183 |
| Number Of American Indian Alaska Native Beneficiaries | 21 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2088 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 312 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5461 |