| National Provider Identifier [NPI]: | 1326120635 |
| Last Name Of The Provider | BASEMAN |
| First Name Of The Provider | DONALD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9410 FOUNTAIN MEDICAL COURT UNIT A102 |
| Street Address 2 Of The Provider | |
| City Of The Provider | BONITA SPRINGS |
| Zip Code Of The Provider | 341354202 |
| 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 | 28 |
| Number Of Services | 6367 |
| Number Of Medicare Beneficiaries | 1014 |
| Total Submitted Charge Amount | 947010 |
| Total Medicare Allowed Amount | 586106.28 |
| Total Medicare Payment Amount | 418023.27 |
| Total Medicare Standardized Payment Amount | 399469.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 418 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 9110 |
| Total Drug Medicare AllowedAmount | 2425.16 |
| Total Drug Medicare PaymentAmount | 2192.08 |
| Total Drug Medicare Standardized Payment Amount | 2192.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 5949 |
| Number Of Medicare Beneficiaries With Medical Services | 1014 |
| Total Medical Submitted Charge Amount | 937900 |
| Total Medical Medicare Allowed Amount | 583681.12 |
| Total Medical Medicare Payment Amount | 415831.19 |
| Total Medical Medicare Standardized Payment Amount | 397277.8 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 350 |
| Number Of Beneficiaries Age 75 to 84 | 461 |
| Number Of Beneficiaries Age Greater 84 | 184 |
| Number Of Female Beneficiaries | 536 |
| Number Of Male Beneficiaries | 478 |
| Number Of Non Hispanic White Beneficiaries | 988 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 989 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2191 |