| National Provider Identifier [NPI]: | 1518902634 |
| Last Name Of The Provider | AL-DEHNEH |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 129 E. REDSTONE AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | CRESTVIEW |
| Zip Code Of The Provider | 325395350 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 4606 |
| Number Of Medicare Beneficiaries | 1751 |
| Total Submitted Charge Amount | 792798 |
| Total Medicare Allowed Amount | 380813.52 |
| Total Medicare Payment Amount | 293610.71 |
| Total Medicare Standardized Payment Amount | 292842.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 160 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 14720 |
| Total Drug Medicare AllowedAmount | 8468.42 |
| Total Drug Medicare PaymentAmount | 6540.51 |
| Total Drug Medicare Standardized Payment Amount | 6540.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 4446 |
| Number Of Medicare Beneficiaries With Medical Services | 1751 |
| Total Medical Submitted Charge Amount | 778078 |
| Total Medical Medicare Allowed Amount | 372345.1 |
| Total Medical Medicare Payment Amount | 287070.2 |
| Total Medical Medicare Standardized Payment Amount | 286301.95 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 207 |
| Number Of Beneficiaries Age 65 to 74 | 591 |
| Number Of Beneficiaries Age 75 to 84 | 678 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 873 |
| Number Of Male Beneficiaries | 878 |
| Number Of Non Hispanic White Beneficiaries | 1604 |
| Number Of Black or African American Beneficiaries | 89 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1436 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 315 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9146 |