| National Provider Identifier [NPI]: | 1417924689 |
| Last Name Of The Provider | DSOUZA |
| First Name Of The Provider | V |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD SC |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 576 STERTHAUS AVE |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ORMOND BEACH |
| Zip Code Of The Provider | 321745128 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 5313 |
| Number Of Medicare Beneficiaries | 968 |
| Total Submitted Charge Amount | 443324.54 |
| Total Medicare Allowed Amount | 439439.92 |
| Total Medicare Payment Amount | 333435.09 |
| Total Medicare Standardized Payment Amount | 334181.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 78 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 3877.58 |
| Total Drug Medicare AllowedAmount | 3877.33 |
| Total Drug Medicare PaymentAmount | 3799.25 |
| Total Drug Medicare Standardized Payment Amount | 3799.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 5235 |
| Number Of Medicare Beneficiaries With Medical Services | 968 |
| Total Medical Submitted Charge Amount | 439446.96 |
| Total Medical Medicare Allowed Amount | 435562.59 |
| Total Medical Medicare Payment Amount | 329635.84 |
| Total Medical Medicare Standardized Payment Amount | 330381.93 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 340 |
| Number Of Beneficiaries Age 75 to 84 | 329 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 495 |
| Number Of Male Beneficiaries | 473 |
| Number Of Non Hispanic White Beneficiaries | 858 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 759 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 29 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 48 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.2946 |