| National Provider Identifier [NPI]: | 1689623019 |
| Last Name Of The Provider | DANCER |
| First Name Of The Provider | JIMMIE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5665 PEACHTREE DUNWOODY RD |
| Street Address 2 Of The Provider | SUITE 500 |
| City Of The Provider | ATLANTA |
| Zip Code Of The Provider | 303421764 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 1232 |
| Number Of Medicare Beneficiaries | 446 |
| Total Submitted Charge Amount | 314641 |
| Total Medicare Allowed Amount | 114962.47 |
| Total Medicare Payment Amount | 89684.71 |
| Total Medicare Standardized Payment Amount | 89931.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 1232 |
| Number Of Medicare Beneficiaries With Medical Services | 446 |
| Total Medical Submitted Charge Amount | 314641 |
| Total Medical Medicare Allowed Amount | 114962.47 |
| Total Medical Medicare Payment Amount | 89684.71 |
| Total Medical Medicare Standardized Payment Amount | 89931.04 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 157 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 239 |
| Number Of Male Beneficiaries | 207 |
| Number Of Non Hispanic White Beneficiaries | 362 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 377 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 64 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.4175 |