| National Provider Identifier [NPI]: | 1518921303 |
| Last Name Of The Provider | LONGWILL |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7700 SW 104TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PINECREST |
| Zip Code Of The Provider | 331563149 |
| 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 | 73 |
| Number Of Services | 6447 |
| Number Of Medicare Beneficiaries | 583 |
| Total Submitted Charge Amount | 509274.41 |
| Total Medicare Allowed Amount | 451859.83 |
| Total Medicare Payment Amount | 337101.35 |
| Total Medicare Standardized Payment Amount | 297561.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 10355 |
| Total Drug Medicare AllowedAmount | 9342.29 |
| Total Drug Medicare PaymentAmount | 7317.67 |
| Total Drug Medicare Standardized Payment Amount | 7317.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 6409 |
| Number Of Medicare Beneficiaries With Medical Services | 583 |
| Total Medical Submitted Charge Amount | 498919.41 |
| Total Medical Medicare Allowed Amount | 442517.54 |
| Total Medical Medicare Payment Amount | 329783.68 |
| Total Medical Medicare Standardized Payment Amount | 290243.4 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 308 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 63 |
| Number Of Female Beneficiaries | 357 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 368 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 190 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 447 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0667 |