| National Provider Identifier [NPI]: | 1245470962 |
| Last Name Of The Provider | LASSITER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | PSY.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 19 MARTINIQUE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336064005 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Clinical Psychologist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 1408 |
| Number Of Medicare Beneficiaries | 167 |
| Total Submitted Charge Amount | 289700 |
| Total Medicare Allowed Amount | 94272.71 |
| Total Medicare Payment Amount | 73553.68 |
| Total Medicare Standardized Payment Amount | 72839.45 |
| 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 | 1408 |
| Number Of Medicare Beneficiaries With Medical Services | 167 |
| Total Medical Submitted Charge Amount | 289700 |
| Total Medical Medicare Allowed Amount | 94272.71 |
| Total Medical Medicare Payment Amount | 73553.68 |
| Total Medical Medicare Standardized Payment Amount | 72839.45 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 129 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 33 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 134 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 3.1 |