| National Provider Identifier [NPI]: | 1215942651 |
| Last Name Of The Provider | EDENS |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 S STEVENS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042654 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 5565 |
| Number Of Medicare Beneficiaries | 2746 |
| Total Submitted Charge Amount | 1262178 |
| Total Medicare Allowed Amount | 402752.31 |
| Total Medicare Payment Amount | 356012.97 |
| Total Medicare Standardized Payment Amount | 354786.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 177 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 708 |
| Total Drug Medicare AllowedAmount | 393.8 |
| Total Drug Medicare PaymentAmount | 285.64 |
| Total Drug Medicare Standardized Payment Amount | 285.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 5388 |
| Number Of Medicare Beneficiaries With Medical Services | 2746 |
| Total Medical Submitted Charge Amount | 1261470 |
| Total Medical Medicare Allowed Amount | 402358.51 |
| Total Medical Medicare Payment Amount | 355727.33 |
| Total Medical Medicare Standardized Payment Amount | 354500.8 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 269 |
| Number Of Beneficiaries Age 65 to 74 | 1460 |
| Number Of Beneficiaries Age 75 to 84 | 804 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 2540 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 2573 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 28 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2375 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 371 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8805 |