| National Provider Identifier [NPI]: | 1336111269 |
| Last Name Of The Provider | ALDER |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 650 ADDISON AVE W |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | TWIN FALLS |
| Zip Code Of The Provider | 833015444 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 4140 |
| Number Of Medicare Beneficiaries | 2396 |
| Total Submitted Charge Amount | 322282 |
| Total Medicare Allowed Amount | 118276.91 |
| Total Medicare Payment Amount | 92836.26 |
| Total Medicare Standardized Payment Amount | 99021.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 178 |
| Number Of Medical Services | 4140 |
| Number Of Medicare Beneficiaries With Medical Services | 2396 |
| Total Medical Submitted Charge Amount | 322282 |
| Total Medical Medicare Allowed Amount | 118276.91 |
| Total Medical Medicare Payment Amount | 92836.26 |
| Total Medical Medicare Standardized Payment Amount | 99021.8 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 405 |
| Number Of Beneficiaries Age 65 to 74 | 872 |
| Number Of Beneficiaries Age 75 to 84 | 740 |
| Number Of Beneficiaries Age Greater 84 | 379 |
| Number Of Female Beneficiaries | 1511 |
| Number Of Male Beneficiaries | 885 |
| Number Of Non Hispanic White Beneficiaries | 2219 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 125 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1779 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 617 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5057 |