| National Provider Identifier [NPI]: | 1952344285 |
| Last Name Of The Provider | LAURIE |
| First Name Of The Provider | SHAUN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1628 N PLAZA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TALLAHASSEE |
| Zip Code Of The Provider | 323082300 |
| 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 | 65 |
| Number Of Services | 11494 |
| Number Of Medicare Beneficiaries | 1134 |
| Total Submitted Charge Amount | 1365280.15 |
| Total Medicare Allowed Amount | 910334.43 |
| Total Medicare Payment Amount | 680332.13 |
| Total Medicare Standardized Payment Amount | 699084.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 179 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 6002.25 |
| Total Drug Medicare AllowedAmount | 3586.75 |
| Total Drug Medicare PaymentAmount | 3474.09 |
| Total Drug Medicare Standardized Payment Amount | 3474.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 11315 |
| Number Of Medicare Beneficiaries With Medical Services | 1134 |
| Total Medical Submitted Charge Amount | 1359277.9 |
| Total Medical Medicare Allowed Amount | 906747.68 |
| Total Medical Medicare Payment Amount | 676858.04 |
| Total Medical Medicare Standardized Payment Amount | 695610.06 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 236 |
| Number Of Beneficiaries Age 65 to 74 | 307 |
| Number Of Beneficiaries Age 75 to 84 | 297 |
| Number Of Beneficiaries Age Greater 84 | 294 |
| Number Of Female Beneficiaries | 702 |
| Number Of Male Beneficiaries | 432 |
| Number Of Non Hispanic White Beneficiaries | 384 |
| Number Of Black or African American Beneficiaries | 730 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 457 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 677 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 46 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.9911 |