| National Provider Identifier [NPI]: | 1508094772 |
| Last Name Of The Provider | DILDINE |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 GROSSMAN DR |
| Street Address 2 Of The Provider | FAMILY MEDICINE |
| City Of The Provider | BRAINTREE |
| Zip Code Of The Provider | 021844997 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 1595 |
| Number Of Medicare Beneficiaries | 140 |
| Total Submitted Charge Amount | 69772 |
| Total Medicare Allowed Amount | 53026.52 |
| Total Medicare Payment Amount | 42523.41 |
| Total Medicare Standardized Payment Amount | 41020.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 2384 |
| Total Drug Medicare AllowedAmount | 1671.41 |
| Total Drug Medicare PaymentAmount | 1636.51 |
| Total Drug Medicare Standardized Payment Amount | 1636.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 118 |
| Number Of Medical Services | 1553 |
| Number Of Medicare Beneficiaries With Medical Services | 140 |
| Total Medical Submitted Charge Amount | 67388 |
| Total Medical Medicare Allowed Amount | 51355.11 |
| Total Medical Medicare Payment Amount | 40886.9 |
| Total Medical Medicare Standardized Payment Amount | 39383.63 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 45 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 64 |
| Number Of Male Beneficiaries | 76 |
| Number Of Non Hispanic White Beneficiaries | 117 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 77 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0205 |