| National Provider Identifier [NPI]: | 1932196433 |
| Last Name Of The Provider | DESPAIN |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2011 CORONA RD |
| Street Address 2 Of The Provider | SUITE 207 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652035922 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 4710 |
| Number Of Medicare Beneficiaries | 973 |
| Total Submitted Charge Amount | 468436 |
| Total Medicare Allowed Amount | 267904.17 |
| Total Medicare Payment Amount | 192808.72 |
| Total Medicare Standardized Payment Amount | 210392.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 51 |
| Number Of Medicare Beneficiaries With Drug Services | 43 |
| Total Drug Submitted ChargeAmount | 18975 |
| Total Drug Medicare AllowedAmount | 12496.36 |
| Total Drug Medicare PaymentAmount | 9742.78 |
| Total Drug Medicare Standardized Payment Amount | 9742.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 4659 |
| Number Of Medicare Beneficiaries With Medical Services | 973 |
| Total Medical Submitted Charge Amount | 449461 |
| Total Medical Medicare Allowed Amount | 255407.81 |
| Total Medical Medicare Payment Amount | 183065.94 |
| Total Medical Medicare Standardized Payment Amount | 200649.3 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 455 |
| Number Of Beneficiaries Age 75 to 84 | 388 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 492 |
| Number Of Male Beneficiaries | 481 |
| Number Of Non Hispanic White Beneficiaries | 949 |
| 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 | 954 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8573 |