| National Provider Identifier [NPI]: | 1275542474 |
| Last Name Of The Provider | CALDERONE |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2100 VIA BELLA BLVD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LAND O LAKES |
| Zip Code Of The Provider | 346395403 |
| 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 | 62 |
| Number Of Services | 5846 |
| Number Of Medicare Beneficiaries | 1117 |
| Total Submitted Charge Amount | 604452 |
| Total Medicare Allowed Amount | 363236.03 |
| Total Medicare Payment Amount | 261973.6 |
| Total Medicare Standardized Payment Amount | 261046.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 66 |
| Total Drug Medicare AllowedAmount | 36.86 |
| Total Drug Medicare PaymentAmount | 31.93 |
| Total Drug Medicare Standardized Payment Amount | 31.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 5833 |
| Number Of Medicare Beneficiaries With Medical Services | 1117 |
| Total Medical Submitted Charge Amount | 604386 |
| Total Medical Medicare Allowed Amount | 363199.17 |
| Total Medical Medicare Payment Amount | 261941.67 |
| Total Medical Medicare Standardized Payment Amount | 261014.38 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 669 |
| Number Of Beneficiaries Age 75 to 84 | 312 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 629 |
| Number Of Male Beneficiaries | 488 |
| Number Of Non Hispanic White Beneficiaries | 1031 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1095 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9341 |