| National Provider Identifier [NPI]: | 1922081538 |
| Last Name Of The Provider | FANNEY |
| First Name Of The Provider | DARYL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4668 PEMBROKE BLVD |
| Street Address 2 Of The Provider | SUITE 117 |
| City Of The Provider | VIRGINIA BEACH |
| Zip Code Of The Provider | 234556423 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 25282 |
| Number Of Medicare Beneficiaries | 1755 |
| Total Submitted Charge Amount | 1664698.5 |
| Total Medicare Allowed Amount | 414851.41 |
| Total Medicare Payment Amount | 314779.92 |
| Total Medicare Standardized Payment Amount | 327470.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 22650 |
| Number Of Medicare Beneficiaries With Drug Services | 302 |
| Total Drug Submitted ChargeAmount | 27791.5 |
| Total Drug Medicare AllowedAmount | 5374.04 |
| Total Drug Medicare PaymentAmount | 4118.32 |
| Total Drug Medicare Standardized Payment Amount | 4118.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 2632 |
| Number Of Medicare Beneficiaries With Medical Services | 1755 |
| Total Medical Submitted Charge Amount | 1636907 |
| Total Medical Medicare Allowed Amount | 409477.37 |
| Total Medical Medicare Payment Amount | 310661.6 |
| Total Medical Medicare Standardized Payment Amount | 323352.48 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 214 |
| Number Of Beneficiaries Age 65 to 74 | 954 |
| Number Of Beneficiaries Age 75 to 84 | 464 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 1071 |
| Number Of Male Beneficiaries | 684 |
| Number Of Non Hispanic White Beneficiaries | 1384 |
| Number Of Black or African American Beneficiaries | 268 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0224 |