| National Provider Identifier [NPI]: | 1487869400 |
| Last Name Of The Provider | CASTELLUCCI |
| First Name Of The Provider | SEAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 3RD AVE W |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | BRADENTON |
| Zip Code Of The Provider | 342058626 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 17900 |
| Number Of Medicare Beneficiaries | 1174 |
| Total Submitted Charge Amount | 2168864.09 |
| Total Medicare Allowed Amount | 649799.69 |
| Total Medicare Payment Amount | 495472.32 |
| Total Medicare Standardized Payment Amount | 500761.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 10209 |
| Number Of Medicare Beneficiaries With Drug Services | 199 |
| Total Drug Submitted ChargeAmount | 347815.53 |
| Total Drug Medicare AllowedAmount | 113405.86 |
| Total Drug Medicare PaymentAmount | 88770.36 |
| Total Drug Medicare Standardized Payment Amount | 88770.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 134 |
| Number Of Medical Services | 7691 |
| Number Of Medicare Beneficiaries With Medical Services | 1174 |
| Total Medical Submitted Charge Amount | 1821048.56 |
| Total Medical Medicare Allowed Amount | 536393.83 |
| Total Medical Medicare Payment Amount | 406701.96 |
| Total Medical Medicare Standardized Payment Amount | 411990.84 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 460 |
| Number Of Beneficiaries Age 75 to 84 | 427 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 344 |
| Number Of Male Beneficiaries | 830 |
| Number Of Non Hispanic White Beneficiaries | 1106 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1094 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 27 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4046 |