| National Provider Identifier [NPI]: | 1578563938 |
| Last Name Of The Provider | FONTANA |
| First Name Of The Provider | ANDRE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3610 SPRINGHILL MEMORIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366081162 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 131 |
| Number Of Services | 5073 |
| Number Of Medicare Beneficiaries | 463 |
| Total Submitted Charge Amount | 587956.5 |
| Total Medicare Allowed Amount | 236163.67 |
| Total Medicare Payment Amount | 169365.4 |
| Total Medicare Standardized Payment Amount | 187589.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1747 |
| Number Of Medicare Beneficiaries With Drug Services | 136 |
| Total Drug Submitted ChargeAmount | 38207 |
| Total Drug Medicare AllowedAmount | 19723.67 |
| Total Drug Medicare PaymentAmount | 14513.65 |
| Total Drug Medicare Standardized Payment Amount | 14513.65 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 3326 |
| Number Of Medicare Beneficiaries With Medical Services | 463 |
| Total Medical Submitted Charge Amount | 549749.5 |
| Total Medical Medicare Allowed Amount | 216440 |
| Total Medical Medicare Payment Amount | 154851.75 |
| Total Medical Medicare Standardized Payment Amount | 173076.1 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 156 |
| Number Of Beneficiaries Age 65 to 74 | 171 |
| Number Of Beneficiaries Age 75 to 84 | 97 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 294 |
| Number Of Male Beneficiaries | 169 |
| Number Of Non Hispanic White Beneficiaries | 275 |
| Number Of Black or African American Beneficiaries | 173 |
| 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 | 363 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 66 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2636 |