| National Provider Identifier [NPI]: | 1417045386 |
| Last Name Of The Provider | YORK |
| First Name Of The Provider | BENNETT |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | D.D.S. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1421 S 28TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | HATTIESBURG |
| Zip Code Of The Provider | 394023108 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Oral Surgery (dentists only) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 558 |
| Number Of Medicare Beneficiaries | 233 |
| Total Submitted Charge Amount | 92694 |
| Total Medicare Allowed Amount | 47134.35 |
| Total Medicare Payment Amount | 35843.14 |
| Total Medicare Standardized Payment Amount | 44871.3 |
| 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 | 35 |
| Number Of Medical Services | 558 |
| Number Of Medicare Beneficiaries With Medical Services | 233 |
| Total Medical Submitted Charge Amount | 92694 |
| Total Medical Medicare Allowed Amount | 47134.35 |
| Total Medical Medicare Payment Amount | 35843.14 |
| Total Medical Medicare Standardized Payment Amount | 44871.3 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 77 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 135 |
| Number Of Male Beneficiaries | 98 |
| Number Of Non Hispanic White Beneficiaries | 196 |
| 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 | 192 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1449 |