| National Provider Identifier [NPI]: | 1386656528 |
| Last Name Of The Provider | DALLER |
| First Name Of The Provider | MEIR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8931 COLONIAL CENTER DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339057809 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 24532 |
| Number Of Medicare Beneficiaries | 2560 |
| Total Submitted Charge Amount | 5986170.52 |
| Total Medicare Allowed Amount | 1806412.57 |
| Total Medicare Payment Amount | 1361873.43 |
| Total Medicare Standardized Payment Amount | 1313958.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1972 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 532648.08 |
| Total Drug Medicare AllowedAmount | 165972.42 |
| Total Drug Medicare PaymentAmount | 128618.43 |
| Total Drug Medicare Standardized Payment Amount | 128618.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 22560 |
| Number Of Medicare Beneficiaries With Medical Services | 2560 |
| Total Medical Submitted Charge Amount | 5453522.44 |
| Total Medical Medicare Allowed Amount | 1640440.15 |
| Total Medical Medicare Payment Amount | 1233255 |
| Total Medical Medicare Standardized Payment Amount | 1185339.76 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 75 |
| Number Of Beneficiaries Age 65 to 74 | 1329 |
| Number Of Beneficiaries Age 75 to 84 | 923 |
| Number Of Beneficiaries Age Greater 84 | 233 |
| Number Of Female Beneficiaries | 580 |
| Number Of Male Beneficiaries | 1980 |
| Number Of Non Hispanic White Beneficiaries | 2421 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 48 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2488 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0146 |