| National Provider Identifier [NPI]: | 1265495782 |
| Last Name Of The Provider | BENBENISTY |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8381 RIVERWALK PARK BLVD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339198760 |
| 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 | 83 |
| Number Of Services | 12875 |
| Number Of Medicare Beneficiaries | 1929 |
| Total Submitted Charge Amount | 1599405 |
| Total Medicare Allowed Amount | 1006693.67 |
| Total Medicare Payment Amount | 746680.32 |
| Total Medicare Standardized Payment Amount | 699995.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 46 |
| Total Drug Submitted ChargeAmount | 9205 |
| Total Drug Medicare AllowedAmount | 8212.18 |
| Total Drug Medicare PaymentAmount | 6428.52 |
| Total Drug Medicare Standardized Payment Amount | 6428.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 12816 |
| Number Of Medicare Beneficiaries With Medical Services | 1928 |
| Total Medical Submitted Charge Amount | 1590200 |
| Total Medical Medicare Allowed Amount | 998481.49 |
| Total Medical Medicare Payment Amount | 740251.8 |
| Total Medical Medicare Standardized Payment Amount | 693566.72 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 55 |
| Number Of Beneficiaries Age 65 to 74 | 1053 |
| Number Of Beneficiaries Age 75 to 84 | 644 |
| Number Of Beneficiaries Age Greater 84 | 177 |
| Number Of Female Beneficiaries | 922 |
| Number Of Male Beneficiaries | 1007 |
| Number Of Non Hispanic White Beneficiaries | 1882 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1898 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9264 |