| National Provider Identifier [NPI]: | 1578534384 |
| Last Name Of The Provider | DAMIANI |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2128 W JEFFERSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRENTON |
| Zip Code Of The Provider | 481835470 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 2421 |
| Number Of Medicare Beneficiaries | 449 |
| Total Submitted Charge Amount | 423976 |
| Total Medicare Allowed Amount | 181918.39 |
| Total Medicare Payment Amount | 138257.67 |
| Total Medicare Standardized Payment Amount | 135922.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 102 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 52660 |
| Total Drug Medicare AllowedAmount | 17594.23 |
| Total Drug Medicare PaymentAmount | 13539.37 |
| Total Drug Medicare Standardized Payment Amount | 13539.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 2319 |
| Number Of Medicare Beneficiaries With Medical Services | 449 |
| Total Medical Submitted Charge Amount | 371316 |
| Total Medical Medicare Allowed Amount | 164324.16 |
| Total Medical Medicare Payment Amount | 124718.3 |
| Total Medical Medicare Standardized Payment Amount | 122383.07 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 182 |
| Number Of Beneficiaries Age 75 to 84 | 122 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 130 |
| Number Of Male Beneficiaries | 319 |
| Number Of Non Hispanic White Beneficiaries | 382 |
| Number Of Black or African American Beneficiaries | 45 |
| 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 | 351 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6142 |