| National Provider Identifier [NPI]: | 1194799569 |
| Last Name Of The Provider | DOMINICK |
| First Name Of The Provider | RAYMOND |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8404 US HIGHWAY 441 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347884016 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 28848 |
| Number Of Medicare Beneficiaries | 4750 |
| Total Submitted Charge Amount | 1021069.62 |
| Total Medicare Allowed Amount | 1013114.62 |
| Total Medicare Payment Amount | 714003.4 |
| Total Medicare Standardized Payment Amount | 719991.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 36 |
| Number Of Drug Services | 8154 |
| Number Of Medicare Beneficiaries With Drug Services | 762 |
| Total Drug Submitted ChargeAmount | 13885.11 |
| Total Drug Medicare AllowedAmount | 13576.93 |
| Total Drug Medicare PaymentAmount | 10649 |
| Total Drug Medicare Standardized Payment Amount | 10649 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 107 |
| Number Of Medical Services | 20694 |
| Number Of Medicare Beneficiaries With Medical Services | 4750 |
| Total Medical Submitted Charge Amount | 1007184.51 |
| Total Medical Medicare Allowed Amount | 999537.69 |
| Total Medical Medicare Payment Amount | 703354.4 |
| Total Medical Medicare Standardized Payment Amount | 709342.2 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 299 |
| Number Of Beneficiaries Age 65 to 74 | 2245 |
| Number Of Beneficiaries Age 75 to 84 | 1661 |
| Number Of Beneficiaries Age Greater 84 | 545 |
| Number Of Female Beneficiaries | 2693 |
| Number Of Male Beneficiaries | 2057 |
| Number Of Non Hispanic White Beneficiaries | 4571 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4482 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 268 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0676 |