| National Provider Identifier [NPI]: | 1679789572 |
| Last Name Of The Provider | DAVID |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13761 MCGREGOR BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339196120 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 1685 |
| Number Of Medicare Beneficiaries | 517 |
| Total Submitted Charge Amount | 124547.84 |
| Total Medicare Allowed Amount | 91824.87 |
| Total Medicare Payment Amount | 59868.05 |
| Total Medicare Standardized Payment Amount | 56779.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 480 |
| Total Drug Medicare AllowedAmount | 31.54 |
| Total Drug Medicare PaymentAmount | 21.7 |
| Total Drug Medicare Standardized Payment Amount | 21.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 1649 |
| Number Of Medicare Beneficiaries With Medical Services | 517 |
| Total Medical Submitted Charge Amount | 124067.84 |
| Total Medical Medicare Allowed Amount | 91793.33 |
| Total Medical Medicare Payment Amount | 59846.35 |
| Total Medical Medicare Standardized Payment Amount | 56757.74 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 92 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 242 |
| Number Of Female Beneficiaries | 302 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | 494 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 464 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5524 |