| National Provider Identifier [NPI]: | 1053382192 |
| Last Name Of The Provider | DONALDSON |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | NP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 967 N BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | YONKERS |
| Zip Code Of The Provider | 107011301 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 167 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 79052 |
| Total Medicare Allowed Amount | 15144.16 |
| Total Medicare Payment Amount | 10494.68 |
| Total Medicare Standardized Payment Amount | 12104.44 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 18 |
| Number Of Medical Services | 167 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 79052 |
| Total Medical Medicare Allowed Amount | 15144.16 |
| Total Medical Medicare Payment Amount | 10494.68 |
| Total Medical Medicare Standardized Payment Amount | 12104.44 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 70 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 91 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 48 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 23 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.7417 |