| National Provider Identifier [NPI]: | 1922189224 |
| Last Name Of The Provider | DASH |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2343 AARON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORT CHARLOTTE |
| Zip Code Of The Provider | 339525305 |
| 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 | 137 |
| Number Of Services | 12234 |
| Number Of Medicare Beneficiaries | 548 |
| Total Submitted Charge Amount | 818522.36 |
| Total Medicare Allowed Amount | 390212.79 |
| Total Medicare Payment Amount | 313193.78 |
| Total Medicare Standardized Payment Amount | 317143.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 24 |
| Number Of Drug Services | 1306 |
| Number Of Medicare Beneficiaries With Drug Services | 303 |
| Total Drug Submitted ChargeAmount | 39594.5 |
| Total Drug Medicare AllowedAmount | 20278.73 |
| Total Drug Medicare PaymentAmount | 17305.73 |
| Total Drug Medicare Standardized Payment Amount | 17305.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 10928 |
| Number Of Medicare Beneficiaries With Medical Services | 548 |
| Total Medical Submitted Charge Amount | 778927.86 |
| Total Medical Medicare Allowed Amount | 369934.06 |
| Total Medical Medicare Payment Amount | 295888.05 |
| Total Medical Medicare Standardized Payment Amount | 299837.36 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 227 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 97 |
| Number Of Female Beneficiaries | 268 |
| Number Of Male Beneficiaries | 280 |
| Number Of Non Hispanic White Beneficiaries | 519 |
| Number Of Black or African American Beneficiaries | 11 |
| 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 | 510 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.0924 |