| National Provider Identifier [NPI]: | 1861446585 |
| Last Name Of The Provider | BORECKY |
| First Name Of The Provider | DERRICK |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 646 VIRGINIA ST |
| Street Address 2 Of The Provider | STE 204 |
| City Of The Provider | DUNEDIN |
| Zip Code Of The Provider | 34698 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 2629 |
| Number Of Medicare Beneficiaries | 414 |
| Total Submitted Charge Amount | 273650 |
| Total Medicare Allowed Amount | 160876.34 |
| Total Medicare Payment Amount | 119932.83 |
| Total Medicare Standardized Payment Amount | 120996.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 219 |
| Number Of Medicare Beneficiaries With Drug Services | 168 |
| Total Drug Submitted ChargeAmount | 11354 |
| Total Drug Medicare AllowedAmount | 5367.12 |
| Total Drug Medicare PaymentAmount | 5239.31 |
| Total Drug Medicare Standardized Payment Amount | 5239.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2410 |
| Number Of Medicare Beneficiaries With Medical Services | 414 |
| Total Medical Submitted Charge Amount | 262296 |
| Total Medical Medicare Allowed Amount | 155509.22 |
| Total Medical Medicare Payment Amount | 114693.52 |
| Total Medical Medicare Standardized Payment Amount | 115756.95 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 115 |
| Number Of Female Beneficiaries | 216 |
| Number Of Male Beneficiaries | 198 |
| Number Of Non Hispanic White Beneficiaries | 400 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 395 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1561 |