| National Provider Identifier [NPI]: | 1164404257 |
| Last Name Of The Provider | AZZARA |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7381 COLLEGE PKWY |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339075548 |
| 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 | 141 |
| Number Of Services | 7668 |
| Number Of Medicare Beneficiaries | 1437 |
| Total Submitted Charge Amount | 540448.2 |
| Total Medicare Allowed Amount | 284790.69 |
| Total Medicare Payment Amount | 205387.58 |
| Total Medicare Standardized Payment Amount | 199471.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 271 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 12790.2 |
| Total Drug Medicare AllowedAmount | 5949.22 |
| Total Drug Medicare PaymentAmount | 5592.73 |
| Total Drug Medicare Standardized Payment Amount | 5592.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 132 |
| Number Of Medical Services | 7397 |
| Number Of Medicare Beneficiaries With Medical Services | 1437 |
| Total Medical Submitted Charge Amount | 527658 |
| Total Medical Medicare Allowed Amount | 278841.47 |
| Total Medical Medicare Payment Amount | 199794.85 |
| Total Medical Medicare Standardized Payment Amount | 193878.99 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 607 |
| Number Of Beneficiaries Age 75 to 84 | 509 |
| Number Of Beneficiaries Age Greater 84 | 215 |
| Number Of Female Beneficiaries | 756 |
| Number Of Male Beneficiaries | 681 |
| Number Of Non Hispanic White Beneficiaries | 1351 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1323 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1086 |