| National Provider Identifier [NPI]: | 1598704637 |
| Last Name Of The Provider | D'AMICO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 187 N MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WALLINGFORD |
| Zip Code Of The Provider | 064923721 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1781 |
| Number Of Medicare Beneficiaries | 456 |
| Total Submitted Charge Amount | 138549 |
| Total Medicare Allowed Amount | 81444.1 |
| Total Medicare Payment Amount | 57917.06 |
| Total Medicare Standardized Payment Amount | 54326.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1781 |
| Number Of Medicare Beneficiaries With Medical Services | 456 |
| Total Medical Submitted Charge Amount | 138549 |
| Total Medical Medicare Allowed Amount | 81444.1 |
| Total Medical Medicare Payment Amount | 57917.06 |
| Total Medical Medicare Standardized Payment Amount | 54326.13 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 199 |
| Number Of Non Hispanic White Beneficiaries | 436 |
| Number Of Black or African American Beneficiaries | |
| 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 | 396 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6495 |