| National Provider Identifier [NPI]: | 1891718631 |
| Last Name Of The Provider | BEASLEY |
| First Name Of The Provider | DONNIE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 310 WHITE OAK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAWTON |
| Zip Code Of The Provider | 490659705 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 133 |
| Number Of Medicare Beneficiaries | 84 |
| Total Submitted Charge Amount | 10399.5 |
| Total Medicare Allowed Amount | 7332.81 |
| Total Medicare Payment Amount | 5410.92 |
| Total Medicare Standardized Payment Amount | 5639.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 165.5 |
| Total Drug Medicare AllowedAmount | 55.74 |
| Total Drug Medicare PaymentAmount | 47.84 |
| Total Drug Medicare Standardized Payment Amount | 47.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 102 |
| Number Of Medicare Beneficiaries With Medical Services | 84 |
| Total Medical Submitted Charge Amount | 10234 |
| Total Medical Medicare Allowed Amount | 7277.07 |
| Total Medical Medicare Payment Amount | 5363.08 |
| Total Medical Medicare Standardized Payment Amount | 5592.1 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 27 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 61 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9096 |