| National Provider Identifier [NPI]: | 1033103122 |
| Last Name Of The Provider | CANNON |
| First Name Of The Provider | D |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 971 LAKELAND DR |
| Street Address 2 Of The Provider | SUITE 1052 |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164643 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 6829 |
| Number Of Medicare Beneficiaries | 1315 |
| Total Submitted Charge Amount | 1188563.38 |
| Total Medicare Allowed Amount | 635856.21 |
| Total Medicare Payment Amount | 486346.09 |
| Total Medicare Standardized Payment Amount | 492667.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 469.44 |
| Total Drug Medicare AllowedAmount | 268.79 |
| Total Drug Medicare PaymentAmount | 163.89 |
| Total Drug Medicare Standardized Payment Amount | 163.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 6817 |
| Number Of Medicare Beneficiaries With Medical Services | 1315 |
| Total Medical Submitted Charge Amount | 1188093.94 |
| Total Medical Medicare Allowed Amount | 635587.42 |
| Total Medical Medicare Payment Amount | 486182.2 |
| Total Medical Medicare Standardized Payment Amount | 492503.7 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 247 |
| Number Of Beneficiaries Age 65 to 74 | 483 |
| Number Of Beneficiaries Age 75 to 84 | 446 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 735 |
| Number Of Male Beneficiaries | 580 |
| Number Of Non Hispanic White Beneficiaries | 997 |
| Number Of Black or African American Beneficiaries | 306 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 951 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 364 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 49 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9975 |