| National Provider Identifier [NPI]: | 1184681876 |
| Last Name Of The Provider | DOLGIN |
| First Name Of The Provider | FREDERICK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 HEALTH PARK BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST AUGUSTINE |
| Zip Code Of The Provider | 320865776 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 3464 |
| Number Of Medicare Beneficiaries | 578 |
| Total Submitted Charge Amount | 344017.88 |
| Total Medicare Allowed Amount | 239301.37 |
| Total Medicare Payment Amount | 184103.59 |
| Total Medicare Standardized Payment Amount | 186111.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 402 |
| Number Of Medicare Beneficiaries With Drug Services | 293 |
| Total Drug Submitted ChargeAmount | 12918 |
| Total Drug Medicare AllowedAmount | 7557.63 |
| Total Drug Medicare PaymentAmount | 7332.2 |
| Total Drug Medicare Standardized Payment Amount | 7332.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 3062 |
| Number Of Medicare Beneficiaries With Medical Services | 578 |
| Total Medical Submitted Charge Amount | 331099.88 |
| Total Medical Medicare Allowed Amount | 231743.74 |
| Total Medical Medicare Payment Amount | 176771.39 |
| Total Medical Medicare Standardized Payment Amount | 178779.42 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 269 |
| Number Of Beneficiaries Age 75 to 84 | 173 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 304 |
| Number Of Male Beneficiaries | 274 |
| Number Of Non Hispanic White Beneficiaries | 556 |
| Number Of Black or African American Beneficiaries | |
| 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 | 545 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0926 |