| National Provider Identifier [NPI]: | 1659402196 |
| Last Name Of The Provider | BUCKLEY |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 316 DEL PRADO BLVD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAPE CORAL |
| Zip Code Of The Provider | 339901710 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 4611 |
| Number Of Medicare Beneficiaries | 1205 |
| Total Submitted Charge Amount | 3746162.09 |
| Total Medicare Allowed Amount | 2162411.12 |
| Total Medicare Payment Amount | 1674638.75 |
| Total Medicare Standardized Payment Amount | 1495840.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 207 |
| Total Drug Medicare AllowedAmount | 32.27 |
| Total Drug Medicare PaymentAmount | 23.87 |
| Total Drug Medicare Standardized Payment Amount | 23.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 4593 |
| Number Of Medicare Beneficiaries With Medical Services | 1205 |
| Total Medical Submitted Charge Amount | 3745955.09 |
| Total Medical Medicare Allowed Amount | 2162378.85 |
| Total Medical Medicare Payment Amount | 1674614.88 |
| Total Medical Medicare Standardized Payment Amount | 1495816.3 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 484 |
| Number Of Beneficiaries Age 75 to 84 | 434 |
| Number Of Beneficiaries Age Greater 84 | 255 |
| Number Of Female Beneficiaries | 545 |
| Number Of Male Beneficiaries | 660 |
| Number Of Non Hispanic White Beneficiaries | 1173 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1149 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1093 |