| National Provider Identifier [NPI]: | 1295716660 |
| Last Name Of The Provider | EDWARDS |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 771 WEST END AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW YORK |
| Zip Code Of The Provider | 100255572 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 4769 |
| Number Of Medicare Beneficiaries | 1959 |
| Total Submitted Charge Amount | 623691.52 |
| Total Medicare Allowed Amount | 200036.3 |
| Total Medicare Payment Amount | 150471.62 |
| Total Medicare Standardized Payment Amount | 136325.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1898 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1995.2 |
| Total Drug Medicare AllowedAmount | 841.74 |
| Total Drug Medicare PaymentAmount | 579.94 |
| Total Drug Medicare Standardized Payment Amount | 579.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2871 |
| Number Of Medicare Beneficiaries With Medical Services | 1959 |
| Total Medical Submitted Charge Amount | 621696.32 |
| Total Medical Medicare Allowed Amount | 199194.56 |
| Total Medical Medicare Payment Amount | 149891.68 |
| Total Medical Medicare Standardized Payment Amount | 135745.51 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 200 |
| Number Of Beneficiaries Age 65 to 74 | 467 |
| Number Of Beneficiaries Age 75 to 84 | 617 |
| Number Of Beneficiaries Age Greater 84 | 675 |
| Number Of Female Beneficiaries | 1091 |
| Number Of Male Beneficiaries | 868 |
| Number Of Non Hispanic White Beneficiaries | 1460 |
| Number Of Black or African American Beneficiaries | 116 |
| Number Of AsianPacific Islander Beneficiaries | 184 |
| Number Of Hispanic Beneficiaries | 129 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 70 |
| Number Of Beneficiaries With Medicare Only Entitlement | 777 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1182 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 41 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.2242 |