| National Provider Identifier [NPI]: | 1740260033 |
| Last Name Of The Provider | MCCOY |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 SW 7TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILLISTON |
| Zip Code Of The Provider | 326962404 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 2235 |
| Number Of Medicare Beneficiaries | 613 |
| Total Submitted Charge Amount | 503300.55 |
| Total Medicare Allowed Amount | 121419.32 |
| Total Medicare Payment Amount | 83730.86 |
| Total Medicare Standardized Payment Amount | 84511.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1470.14 |
| Total Drug Medicare AllowedAmount | 966.73 |
| Total Drug Medicare PaymentAmount | 932.81 |
| Total Drug Medicare Standardized Payment Amount | 932.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2179 |
| Number Of Medicare Beneficiaries With Medical Services | 613 |
| Total Medical Submitted Charge Amount | 501830.41 |
| Total Medical Medicare Allowed Amount | 120452.59 |
| Total Medical Medicare Payment Amount | 82798.05 |
| Total Medical Medicare Standardized Payment Amount | 83578.51 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 362 |
| Number Of Male Beneficiaries | 251 |
| Number Of Non Hispanic White Beneficiaries | 534 |
| Number Of Black or African American Beneficiaries | 62 |
| 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 | 424 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 189 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.395 |