| National Provider Identifier [NPI]: | 1649262668 |
| Last Name Of The Provider | DOLENSKY |
| First Name Of The Provider | DIANE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 463 OHIO PIKE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | CINCINNATI |
| Zip Code Of The Provider | 452553721 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 508 |
| Number Of Medicare Beneficiaries | 163 |
| Total Submitted Charge Amount | 48676 |
| Total Medicare Allowed Amount | 35914.02 |
| Total Medicare Payment Amount | 22901.25 |
| Total Medicare Standardized Payment Amount | 24372.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 37 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 1419 |
| Total Drug Medicare AllowedAmount | 925.19 |
| Total Drug Medicare PaymentAmount | 894.78 |
| Total Drug Medicare Standardized Payment Amount | 894.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 471 |
| Number Of Medicare Beneficiaries With Medical Services | 163 |
| Total Medical Submitted Charge Amount | 47257 |
| Total Medical Medicare Allowed Amount | 34988.83 |
| Total Medical Medicare Payment Amount | 22006.47 |
| Total Medical Medicare Standardized Payment Amount | 23477.49 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 81 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 135 |
| Number Of Male Beneficiaries | 28 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8722 |