| National Provider Identifier [NPI]: | 1144269986 |
| Last Name Of The Provider | D'AMATO |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 211 QUAKER LN |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | WEST WARWICK |
| Zip Code Of The Provider | 028932151 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 356 |
| Number Of Medicare Beneficiaries | 46 |
| Total Submitted Charge Amount | 76225.01 |
| Total Medicare Allowed Amount | 28066.37 |
| Total Medicare Payment Amount | 19561.6 |
| Total Medicare Standardized Payment Amount | 20963.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 92 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1520 |
| Total Drug Medicare AllowedAmount | 177.48 |
| Total Drug Medicare PaymentAmount | 136.49 |
| Total Drug Medicare Standardized Payment Amount | 136.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 13 |
| Number Of Medical Services | 264 |
| Number Of Medicare Beneficiaries With Medical Services | 46 |
| Total Medical Submitted Charge Amount | 74705.01 |
| Total Medical Medicare Allowed Amount | 27888.89 |
| Total Medical Medicare Payment Amount | 19425.11 |
| Total Medical Medicare Standardized Payment Amount | 20826.83 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 23 |
| Number Of Beneficiaries Age 75 to 84 | 11 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 24 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.294 |