| National Provider Identifier [NPI]: | 1598766917 |
| Last Name Of The Provider | MCCORMACK |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D., PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2001 WEBBER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 342395288 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 11213 |
| Number Of Medicare Beneficiaries | 5543 |
| Total Submitted Charge Amount | 2245106.13 |
| Total Medicare Allowed Amount | 566997.09 |
| Total Medicare Payment Amount | 436596.81 |
| Total Medicare Standardized Payment Amount | 331650.89 |
| 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 | 41 |
| Number Of Medical Services | 11213 |
| Number Of Medicare Beneficiaries With Medical Services | 5543 |
| Total Medical Submitted Charge Amount | 2245106.13 |
| Total Medical Medicare Allowed Amount | 566997.09 |
| Total Medical Medicare Payment Amount | 436596.81 |
| Total Medical Medicare Standardized Payment Amount | 331650.89 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 137 |
| Number Of Beneficiaries Age 65 to 74 | 2313 |
| Number Of Beneficiaries Age 75 to 84 | 2190 |
| Number Of Beneficiaries Age Greater 84 | 903 |
| Number Of Female Beneficiaries | 2627 |
| Number Of Male Beneficiaries | 2916 |
| Number Of Non Hispanic White Beneficiaries | 5393 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 66 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 133 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0682 |