| National Provider Identifier [NPI]: | 1174671820 |
| Last Name Of The Provider | BLAKE |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1550 BARKLEY CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339074539 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 7161 |
| Number Of Medicare Beneficiaries | 2961 |
| Total Submitted Charge Amount | 1834786 |
| Total Medicare Allowed Amount | 869785.77 |
| Total Medicare Payment Amount | 670052.58 |
| Total Medicare Standardized Payment Amount | 656611.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1024 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 115500 |
| Total Drug Medicare AllowedAmount | 53562.41 |
| Total Drug Medicare PaymentAmount | 40990.28 |
| Total Drug Medicare Standardized Payment Amount | 40990.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 6137 |
| Number Of Medicare Beneficiaries With Medical Services | 2961 |
| Total Medical Submitted Charge Amount | 1719286 |
| Total Medical Medicare Allowed Amount | 816223.36 |
| Total Medical Medicare Payment Amount | 629062.3 |
| Total Medical Medicare Standardized Payment Amount | 615621.12 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 193 |
| Number Of Beneficiaries Age 65 to 74 | 1037 |
| Number Of Beneficiaries Age 75 to 84 | 1147 |
| Number Of Beneficiaries Age Greater 84 | 584 |
| Number Of Female Beneficiaries | 1383 |
| Number Of Male Beneficiaries | 1578 |
| Number Of Non Hispanic White Beneficiaries | 2706 |
| Number Of Black or African American Beneficiaries | 73 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 120 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2673 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 288 |
| Percent Of With Atrial Fibrillation | 42 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.6075 |