| National Provider Identifier [NPI]: | 1750374005 |
| Last Name Of The Provider | ANTONIO |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 95 HARRIS RD |
| Street Address 2 Of The Provider | BUILDING 5 |
| City Of The Provider | KILMARNOCK |
| Zip Code Of The Provider | 224823845 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 5968 |
| Number Of Medicare Beneficiaries | 775 |
| Total Submitted Charge Amount | 574235 |
| Total Medicare Allowed Amount | 225820.03 |
| Total Medicare Payment Amount | 162656.03 |
| Total Medicare Standardized Payment Amount | 167011.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2790 |
| Number Of Medicare Beneficiaries With Drug Services | 287 |
| Total Drug Submitted ChargeAmount | 33349 |
| Total Drug Medicare AllowedAmount | 23225.98 |
| Total Drug Medicare PaymentAmount | 17737.93 |
| Total Drug Medicare Standardized Payment Amount | 17737.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 3178 |
| Number Of Medicare Beneficiaries With Medical Services | 775 |
| Total Medical Submitted Charge Amount | 540886 |
| Total Medical Medicare Allowed Amount | 202594.05 |
| Total Medical Medicare Payment Amount | 144918.1 |
| Total Medical Medicare Standardized Payment Amount | 149273.09 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 315 |
| Number Of Beneficiaries Age 75 to 84 | 229 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 491 |
| Number Of Male Beneficiaries | 284 |
| Number Of Non Hispanic White Beneficiaries | 654 |
| Number Of Black or African American Beneficiaries | 104 |
| 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 | 672 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 103 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0023 |