| National Provider Identifier [NPI]: | 1003064577 |
| Last Name Of The Provider | DANCE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1814 LINCOLN WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | COEUR D ALENE |
| Zip Code Of The Provider | 838142540 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 3717 |
| Number Of Medicare Beneficiaries | 962 |
| Total Submitted Charge Amount | 1551959.5 |
| Total Medicare Allowed Amount | 677998.85 |
| Total Medicare Payment Amount | 497803.48 |
| Total Medicare Standardized Payment Amount | 527229.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 572 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 245375.5 |
| Total Drug Medicare AllowedAmount | 217467.8 |
| Total Drug Medicare PaymentAmount | 158884.83 |
| Total Drug Medicare Standardized Payment Amount | 158884.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 3145 |
| Number Of Medicare Beneficiaries With Medical Services | 962 |
| Total Medical Submitted Charge Amount | 1306584 |
| Total Medical Medicare Allowed Amount | 460531.05 |
| Total Medical Medicare Payment Amount | 338918.65 |
| Total Medical Medicare Standardized Payment Amount | 368345.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 80 |
| Number Of Beneficiaries Age 65 to 74 | 404 |
| Number Of Beneficiaries Age 75 to 84 | 341 |
| Number Of Beneficiaries Age Greater 84 | 137 |
| Number Of Female Beneficiaries | 548 |
| Number Of Male Beneficiaries | 414 |
| Number Of Non Hispanic White Beneficiaries | 923 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 807 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0288 |