| National Provider Identifier [NPI]: | 1760553630 |
| Last Name Of The Provider | NEILY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21550 ANGELA LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENICE |
| Zip Code Of The Provider | 342932017 |
| 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 | 114 |
| Number Of Services | 31703 |
| Number Of Medicare Beneficiaries | 3511 |
| Total Submitted Charge Amount | 3179557.19 |
| Total Medicare Allowed Amount | 2072259.72 |
| Total Medicare Payment Amount | 1536934.62 |
| Total Medicare Standardized Payment Amount | 1518170.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 120 |
| Number Of Medicare Beneficiaries With Drug Services | 101 |
| Total Drug Submitted ChargeAmount | 18522.3 |
| Total Drug Medicare AllowedAmount | 18303.34 |
| Total Drug Medicare PaymentAmount | 14284.44 |
| Total Drug Medicare Standardized Payment Amount | 14284.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 112 |
| Number Of Medical Services | 31583 |
| Number Of Medicare Beneficiaries With Medical Services | 3511 |
| Total Medical Submitted Charge Amount | 3161034.89 |
| Total Medical Medicare Allowed Amount | 2053956.38 |
| Total Medical Medicare Payment Amount | 1522650.18 |
| Total Medical Medicare Standardized Payment Amount | 1503886.14 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 1563 |
| Number Of Beneficiaries Age 75 to 84 | 1429 |
| Number Of Beneficiaries Age Greater 84 | 462 |
| Number Of Female Beneficiaries | 1780 |
| Number Of Male Beneficiaries | 1731 |
| Number Of Non Hispanic White Beneficiaries | 3421 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3465 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9803 |