| National Provider Identifier [NPI]: | 1962528901 |
| Last Name Of The Provider | DIFERDINANDO |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2659 S WOODLAND BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DELAND |
| Zip Code Of The Provider | 327208601 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 632 |
| Number Of Medicare Beneficiaries | 371 |
| Total Submitted Charge Amount | 84480 |
| Total Medicare Allowed Amount | 78909.05 |
| Total Medicare Payment Amount | 61217.63 |
| Total Medicare Standardized Payment Amount | 61730.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 5 |
| Number Of Medical Services | 632 |
| Number Of Medicare Beneficiaries With Medical Services | 371 |
| Total Medical Submitted Charge Amount | 84480 |
| Total Medical Medicare Allowed Amount | 78909.05 |
| Total Medical Medicare Payment Amount | 61217.63 |
| Total Medical Medicare Standardized Payment Amount | 61730.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 108 |
| Number Of Beneficiaries Age Greater 84 | 38 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | 319 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 319 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0628 |