| National Provider Identifier [NPI]: | 1396745006 |
| Last Name Of The Provider | DIPASCO |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1865 VETERANS PARK DR |
| Street Address 2 Of The Provider | SUITE 202 |
| City Of The Provider | NAPLES |
| Zip Code Of The Provider | 341090447 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1478 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 71594.81 |
| Total Medicare Allowed Amount | 52029.15 |
| Total Medicare Payment Amount | 39516.62 |
| Total Medicare Standardized Payment Amount | 39020.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 795 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 15280.8 |
| Total Drug Medicare AllowedAmount | 11766.69 |
| Total Drug Medicare PaymentAmount | 9455.06 |
| Total Drug Medicare Standardized Payment Amount | 9455.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 683 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 56314.01 |
| Total Medical Medicare Allowed Amount | 40262.46 |
| Total Medical Medicare Payment Amount | 30061.56 |
| Total Medical Medicare Standardized Payment Amount | 29565.9 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 0 |
| Number Of Beneficiaries Age 65 to 74 | 32 |
| Number Of Beneficiaries Age 75 to 84 | 37 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 52 |
| 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 | 94 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0925 |