| National Provider Identifier [NPI]: | 1831161660 |
| Last Name Of The Provider | DESAUTEL |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 609 W HIGHLAND BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | INVERNESS |
| Zip Code Of The Provider | 344524638 |
| 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 | 113 |
| Number Of Services | 27978 |
| Number Of Medicare Beneficiaries | 2124 |
| Total Submitted Charge Amount | 1738269.91 |
| Total Medicare Allowed Amount | 624752.77 |
| Total Medicare Payment Amount | 478599.22 |
| Total Medicare Standardized Payment Amount | 478139.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 15524 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 173791.97 |
| Total Drug Medicare AllowedAmount | 78060.88 |
| Total Drug Medicare PaymentAmount | 60044.86 |
| Total Drug Medicare Standardized Payment Amount | 60044.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 12454 |
| Number Of Medicare Beneficiaries With Medical Services | 2124 |
| Total Medical Submitted Charge Amount | 1564477.94 |
| Total Medical Medicare Allowed Amount | 546691.89 |
| Total Medical Medicare Payment Amount | 418554.36 |
| Total Medical Medicare Standardized Payment Amount | 418094.47 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 800 |
| Number Of Beneficiaries Age 75 to 84 | 873 |
| Number Of Beneficiaries Age Greater 84 | 335 |
| Number Of Female Beneficiaries | 612 |
| Number Of Male Beneficiaries | 1512 |
| Number Of Non Hispanic White Beneficiaries | 2021 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1944 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3079 |