| National Provider Identifier [NPI]: | 1043207988 |
| Last Name Of The Provider | LONGOBARDO |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19 MIRACLE LN |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | CROSSVILLE |
| Zip Code Of The Provider | 385557654 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 5856 |
| Number Of Medicare Beneficiaries | 1446 |
| Total Submitted Charge Amount | 236777.67 |
| Total Medicare Allowed Amount | 220162.67 |
| Total Medicare Payment Amount | 156568.86 |
| Total Medicare Standardized Payment Amount | 171557.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 1900.3 |
| Total Drug Medicare AllowedAmount | 139.21 |
| Total Drug Medicare PaymentAmount | 102 |
| Total Drug Medicare Standardized Payment Amount | 102 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 5778 |
| Number Of Medicare Beneficiaries With Medical Services | 1445 |
| Total Medical Submitted Charge Amount | 234877.37 |
| Total Medical Medicare Allowed Amount | 220023.46 |
| Total Medical Medicare Payment Amount | 156466.86 |
| Total Medical Medicare Standardized Payment Amount | 171455.43 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 520 |
| Number Of Beneficiaries Age 75 to 84 | 533 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 772 |
| Number Of Male Beneficiaries | 674 |
| Number Of Non Hispanic White Beneficiaries | 1430 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 214 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4732 |