| National Provider Identifier [NPI]: | 1508821844 |
| Last Name Of The Provider | DONOVAN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2023 PROFESSIONAL CENTER DRIVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORANGE PARK |
| Zip Code Of The Provider | 32073 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4669 |
| Number Of Medicare Beneficiaries | 1648 |
| Total Submitted Charge Amount | 1283152 |
| Total Medicare Allowed Amount | 739520.77 |
| Total Medicare Payment Amount | 544411.92 |
| Total Medicare Standardized Payment Amount | 532625.69 |
| 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 | 65 |
| Number Of Medical Services | 4669 |
| Number Of Medicare Beneficiaries With Medical Services | 1648 |
| Total Medical Submitted Charge Amount | 1283152 |
| Total Medical Medicare Allowed Amount | 739520.77 |
| Total Medical Medicare Payment Amount | 544411.92 |
| Total Medical Medicare Standardized Payment Amount | 532625.69 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 729 |
| Number Of Beneficiaries Age 75 to 84 | 611 |
| Number Of Beneficiaries Age Greater 84 | 239 |
| Number Of Female Beneficiaries | 1014 |
| Number Of Male Beneficiaries | 634 |
| Number Of Non Hispanic White Beneficiaries | 1514 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 37 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1556 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 92 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0917 |