| National Provider Identifier [NPI]: | 1144398926 |
| Last Name Of The Provider | DOBEN |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | SUITE 505 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071270 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 522 |
| Number Of Medicare Beneficiaries | 237 |
| Total Submitted Charge Amount | 213470 |
| Total Medicare Allowed Amount | 91448.23 |
| Total Medicare Payment Amount | 71694.12 |
| Total Medicare Standardized Payment Amount | 69852.7 |
| 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 | 56 |
| Number Of Medical Services | 522 |
| Number Of Medicare Beneficiaries With Medical Services | 237 |
| Total Medical Submitted Charge Amount | 213470 |
| Total Medical Medicare Allowed Amount | 91448.23 |
| Total Medical Medicare Payment Amount | 71694.12 |
| Total Medical Medicare Standardized Payment Amount | 69852.7 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 86 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 133 |
| Number Of Non Hispanic White Beneficiaries | 205 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 143 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 94 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 59 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 14 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.0588 |