| National Provider Identifier [NPI]: | 1598065211 |
| Last Name Of The Provider | DOLAN |
| First Name Of The Provider | MINDY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 202 S 22ND ST STE 106 |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336056331 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 1985 |
| Number Of Medicare Beneficiaries | 447 |
| Total Submitted Charge Amount | 341148.52 |
| Total Medicare Allowed Amount | 189513.58 |
| Total Medicare Payment Amount | 148704.37 |
| Total Medicare Standardized Payment Amount | 171737.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 170 |
| Number Of Medicare Beneficiaries With Drug Services | 106 |
| Total Drug Submitted ChargeAmount | 4711.48 |
| Total Drug Medicare AllowedAmount | 1413.03 |
| Total Drug Medicare PaymentAmount | 1337.93 |
| Total Drug Medicare Standardized Payment Amount | 1337.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1815 |
| Number Of Medicare Beneficiaries With Medical Services | 447 |
| Total Medical Submitted Charge Amount | 336437.04 |
| Total Medical Medicare Allowed Amount | 188100.55 |
| Total Medical Medicare Payment Amount | 147366.44 |
| Total Medical Medicare Standardized Payment Amount | 170399.52 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 88 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 127 |
| Number Of Female Beneficiaries | 274 |
| Number Of Male Beneficiaries | 173 |
| Number Of Non Hispanic White Beneficiaries | 230 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 124 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 115 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 332 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 64 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 40 |
| Percent Of With Depression | 60 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 32 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4498 |