| National Provider Identifier [NPI]: | 1013984368 |
| Last Name Of The Provider | DASE |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 724 STONE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TALLADEGA |
| Zip Code Of The Provider | 351602219 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 41 |
| Number Of Services | 1860 |
| Number Of Medicare Beneficiaries | 120 |
| Total Submitted Charge Amount | 57997 |
| Total Medicare Allowed Amount | 40555.3 |
| Total Medicare Payment Amount | 31300.03 |
| Total Medicare Standardized Payment Amount | 33056.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1530 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 24990 |
| Total Drug Medicare AllowedAmount | 19871.82 |
| Total Drug Medicare PaymentAmount | 15313.66 |
| Total Drug Medicare Standardized Payment Amount | 15313.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 330 |
| Number Of Medicare Beneficiaries With Medical Services | 120 |
| Total Medical Submitted Charge Amount | 33007 |
| Total Medical Medicare Allowed Amount | 20683.48 |
| Total Medical Medicare Payment Amount | 15986.37 |
| Total Medical Medicare Standardized Payment Amount | 17742.53 |
| Average Age Of Beneficiaries | 56 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 33 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 120 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 74 |
| 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 | 62 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8995 |