| National Provider Identifier [NPI]: | 1851392831 |
| Last Name Of The Provider | DONELAN |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 E FLETCHER AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336134656 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 6363 |
| Number Of Medicare Beneficiaries | 1017 |
| Total Submitted Charge Amount | 357237.4 |
| Total Medicare Allowed Amount | 308172.75 |
| Total Medicare Payment Amount | 214338.15 |
| Total Medicare Standardized Payment Amount | 212178.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 393 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 890 |
| Total Drug Medicare AllowedAmount | 700.77 |
| Total Drug Medicare PaymentAmount | 515.84 |
| Total Drug Medicare Standardized Payment Amount | 515.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 5970 |
| Number Of Medicare Beneficiaries With Medical Services | 1017 |
| Total Medical Submitted Charge Amount | 356347.4 |
| Total Medical Medicare Allowed Amount | 307471.98 |
| Total Medical Medicare Payment Amount | 213822.31 |
| Total Medical Medicare Standardized Payment Amount | 211662.9 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 417 |
| Number Of Beneficiaries Age 75 to 84 | 370 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 505 |
| Number Of Male Beneficiaries | 512 |
| Number Of Non Hispanic White Beneficiaries | 940 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 976 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0459 |