| National Provider Identifier [NPI]: | 1255303210 |
| Last Name Of The Provider | PALMER |
| 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 | 1819 CAREW ST |
| Street Address 2 Of The Provider | ATTENTION: POLLY BALOSKI |
| City Of The Provider | FORT WAYNE |
| Zip Code Of The Provider | 468054705 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 6063 |
| Number Of Medicare Beneficiaries | 3525 |
| Total Submitted Charge Amount | 1137411 |
| Total Medicare Allowed Amount | 262905.37 |
| Total Medicare Payment Amount | 191097.54 |
| Total Medicare Standardized Payment Amount | 202291.01 |
| 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 | 63 |
| Number Of Medical Services | 6063 |
| Number Of Medicare Beneficiaries With Medical Services | 3525 |
| Total Medical Submitted Charge Amount | 1137411 |
| Total Medical Medicare Allowed Amount | 262905.37 |
| Total Medical Medicare Payment Amount | 191097.54 |
| Total Medical Medicare Standardized Payment Amount | 202291.01 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 585 |
| Number Of Beneficiaries Age 65 to 74 | 1343 |
| Number Of Beneficiaries Age 75 to 84 | 1035 |
| Number Of Beneficiaries Age Greater 84 | 562 |
| Number Of Female Beneficiaries | 1820 |
| Number Of Male Beneficiaries | 1705 |
| Number Of Non Hispanic White Beneficiaries | 3314 |
| Number Of Black or African American Beneficiaries | 129 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2812 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 713 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4985 |