| National Provider Identifier [NPI]: | 1689670010 |
| Last Name Of The Provider | ELLIOTT |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1225 JACARANDA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342924521 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 10660 |
| Number Of Medicare Beneficiaries | 1763 |
| Total Submitted Charge Amount | 1078012.1 |
| Total Medicare Allowed Amount | 544966.98 |
| Total Medicare Payment Amount | 405090.82 |
| Total Medicare Standardized Payment Amount | 411001.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 177 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 16080 |
| Total Drug Medicare AllowedAmount | 6720.33 |
| Total Drug Medicare PaymentAmount | 5264.49 |
| Total Drug Medicare Standardized Payment Amount | 5264.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 10483 |
| Number Of Medicare Beneficiaries With Medical Services | 1763 |
| Total Medical Submitted Charge Amount | 1061932.1 |
| Total Medical Medicare Allowed Amount | 538246.65 |
| Total Medical Medicare Payment Amount | 399826.33 |
| Total Medical Medicare Standardized Payment Amount | 405737.27 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 713 |
| Number Of Beneficiaries Age Greater 84 | 501 |
| Number Of Female Beneficiaries | 829 |
| Number Of Male Beneficiaries | 934 |
| Number Of Non Hispanic White Beneficiaries | 1710 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1677 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 33 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4224 |