| National Provider Identifier [NPI]: | 1417916073 |
| Last Name Of The Provider | DUMONT |
| First Name Of The Provider | DON |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 761 45TH AVE |
| Street Address 2 Of The Provider | STE 108 |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 463212893 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4022 |
| Number Of Medicare Beneficiaries | 853 |
| Total Submitted Charge Amount | 725254.58 |
| Total Medicare Allowed Amount | 348206.56 |
| Total Medicare Payment Amount | 264584.9 |
| Total Medicare Standardized Payment Amount | 277639.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 470 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 33299.58 |
| Total Drug Medicare AllowedAmount | 13880.52 |
| Total Drug Medicare PaymentAmount | 10889.62 |
| Total Drug Medicare Standardized Payment Amount | 10889.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 3552 |
| Number Of Medicare Beneficiaries With Medical Services | 853 |
| Total Medical Submitted Charge Amount | 691955 |
| Total Medical Medicare Allowed Amount | 334326.04 |
| Total Medical Medicare Payment Amount | 253695.28 |
| Total Medical Medicare Standardized Payment Amount | 266750.32 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 330 |
| Number Of Beneficiaries Age 75 to 84 | 268 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 453 |
| Number Of Male Beneficiaries | 400 |
| Number Of Non Hispanic White Beneficiaries | 711 |
| Number Of Black or African American Beneficiaries | 90 |
| 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 | 714 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 29 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 71 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.2936 |