| National Provider Identifier [NPI]: | 1285682377 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 E DIXIE AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347487600 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 211 |
| Number Of Services | 61434 |
| Number Of Medicare Beneficiaries | 9092 |
| Total Submitted Charge Amount | 2896453 |
| Total Medicare Allowed Amount | 1389118.32 |
| Total Medicare Payment Amount | 1117092.85 |
| Total Medicare Standardized Payment Amount | 1137402.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 47473 |
| Number Of Medicare Beneficiaries With Drug Services | 804 |
| Total Drug Submitted ChargeAmount | 124587 |
| Total Drug Medicare AllowedAmount | 16106.96 |
| Total Drug Medicare PaymentAmount | 12510.66 |
| Total Drug Medicare Standardized Payment Amount | 12510.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 203 |
| Number Of Medical Services | 13961 |
| Number Of Medicare Beneficiaries With Medical Services | 9081 |
| Total Medical Submitted Charge Amount | 2771866 |
| Total Medical Medicare Allowed Amount | 1373011.36 |
| Total Medical Medicare Payment Amount | 1104582.19 |
| Total Medical Medicare Standardized Payment Amount | 1124891.74 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 378 |
| Number Of Beneficiaries Age 65 to 74 | 4290 |
| Number Of Beneficiaries Age 75 to 84 | 3462 |
| Number Of Beneficiaries Age Greater 84 | 962 |
| Number Of Female Beneficiaries | 5532 |
| Number Of Male Beneficiaries | 3560 |
| Number Of Non Hispanic White Beneficiaries | 8622 |
| Number Of Black or African American Beneficiaries | 177 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 146 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 98 |
| Number Of Beneficiaries With Medicare Only Entitlement | 8585 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 507 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3542 |