| National Provider Identifier [NPI]: | 1669403432 |
| Last Name Of The Provider | DALTON |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 676 N SAINT CLAIR ST |
| Street Address 2 Of The Provider | SUITE 1835 |
| City Of The Provider | CHICAGO |
| Zip Code Of The Provider | 606112927 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 7102 |
| Number Of Medicare Beneficiaries | 1161 |
| Total Submitted Charge Amount | 2202096 |
| Total Medicare Allowed Amount | 517034.8 |
| Total Medicare Payment Amount | 397615.44 |
| Total Medicare Standardized Payment Amount | 374621.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 592 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 343096 |
| Total Drug Medicare AllowedAmount | 87423.69 |
| Total Drug Medicare PaymentAmount | 68242.85 |
| Total Drug Medicare Standardized Payment Amount | 68242.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 6510 |
| Number Of Medicare Beneficiaries With Medical Services | 1161 |
| Total Medical Submitted Charge Amount | 1859000 |
| Total Medical Medicare Allowed Amount | 429611.11 |
| Total Medical Medicare Payment Amount | 329372.59 |
| Total Medical Medicare Standardized Payment Amount | 306378.83 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 566 |
| Number Of Beneficiaries Age 75 to 84 | 418 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 175 |
| Number Of Male Beneficiaries | 986 |
| Number Of Non Hispanic White Beneficiaries | 991 |
| Number Of Black or African American Beneficiaries | 90 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 30 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0644 |