| National Provider Identifier [NPI]: | 1316912413 |
| Last Name Of The Provider | DONNINI |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1550 YANKEE PARK PL |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | CENTERVILLE |
| Zip Code Of The Provider | 454581838 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 5211 |
| Number Of Medicare Beneficiaries | 507 |
| Total Submitted Charge Amount | 471746 |
| Total Medicare Allowed Amount | 221425.56 |
| Total Medicare Payment Amount | 171301.6 |
| Total Medicare Standardized Payment Amount | 166342.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 2860 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 21080 |
| Total Drug Medicare AllowedAmount | 9307.16 |
| Total Drug Medicare PaymentAmount | 7292.06 |
| Total Drug Medicare Standardized Payment Amount | 7292.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 55 |
| Number Of Medical Services | 2351 |
| Number Of Medicare Beneficiaries With Medical Services | 507 |
| Total Medical Submitted Charge Amount | 450666 |
| Total Medical Medicare Allowed Amount | 212118.4 |
| Total Medical Medicare Payment Amount | 164009.54 |
| Total Medical Medicare Standardized Payment Amount | 159050.03 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 356 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 192 |
| Number Of Non Hispanic White Beneficiaries | 442 |
| Number Of Black or African American Beneficiaries | 53 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 256 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 251 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 50 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5768 |