| National Provider Identifier [NPI]: | 1598719411 |
| Last Name Of The Provider | BAGNOLI |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1220 SLIGH BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328061108 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 2076 |
| Number Of Medicare Beneficiaries | 494 |
| Total Submitted Charge Amount | 285148 |
| Total Medicare Allowed Amount | 216120.82 |
| Total Medicare Payment Amount | 166930.89 |
| Total Medicare Standardized Payment Amount | 168666.94 |
| 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 | 12 |
| Number Of Medical Services | 2076 |
| Number Of Medicare Beneficiaries With Medical Services | 494 |
| Total Medical Submitted Charge Amount | 285148 |
| Total Medical Medicare Allowed Amount | 216120.82 |
| Total Medical Medicare Payment Amount | 166930.89 |
| Total Medical Medicare Standardized Payment Amount | 168666.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 162 |
| Number Of Beneficiaries Age 75 to 84 | 164 |
| Number Of Beneficiaries Age Greater 84 | 105 |
| Number Of Female Beneficiaries | 263 |
| Number Of Male Beneficiaries | 231 |
| Number Of Non Hispanic White Beneficiaries | 397 |
| Number Of Black or African American Beneficiaries | 49 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 404 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 90 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 37 |
| Average HCC Risk Score Of Beneficiaries | 2.1839 |