| National Provider Identifier [NPI]: | 1578528683 |
| Last Name Of The Provider | ROBERTSON |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2828 S MCCALL RD |
| Street Address 2 Of The Provider | STE 21 |
| City Of The Provider | ENGLEWOOD |
| Zip Code Of The Provider | 342247791 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 8803 |
| Number Of Medicare Beneficiaries | 1171 |
| Total Submitted Charge Amount | 802420.37 |
| Total Medicare Allowed Amount | 382423.47 |
| Total Medicare Payment Amount | 275262.82 |
| Total Medicare Standardized Payment Amount | 277003.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 883 |
| Number Of Medicare Beneficiaries With Drug Services | 340 |
| Total Drug Submitted ChargeAmount | 10607.25 |
| Total Drug Medicare AllowedAmount | 5454.17 |
| Total Drug Medicare PaymentAmount | 4717.4 |
| Total Drug Medicare Standardized Payment Amount | 4717.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 7920 |
| Number Of Medicare Beneficiaries With Medical Services | 1171 |
| Total Medical Submitted Charge Amount | 791813.12 |
| Total Medical Medicare Allowed Amount | 376969.3 |
| Total Medical Medicare Payment Amount | 270545.42 |
| Total Medical Medicare Standardized Payment Amount | 272286.53 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 575 |
| Number Of Beneficiaries Age 75 to 84 | 371 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 626 |
| Number Of Male Beneficiaries | 545 |
| Number Of Non Hispanic White Beneficiaries | 1138 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1086 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9402 |