| National Provider Identifier [NPI]: | 1982667903 |
| Last Name Of The Provider | DONATELLI |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 ROGERS ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRINCETON |
| Zip Code Of The Provider | 247403636 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 7978 |
| Number Of Medicare Beneficiaries | 1554 |
| Total Submitted Charge Amount | 497619.4 |
| Total Medicare Allowed Amount | 311270.11 |
| Total Medicare Payment Amount | 218716.77 |
| Total Medicare Standardized Payment Amount | 236007.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1571 |
| Number Of Medicare Beneficiaries With Drug Services | 305 |
| Total Drug Submitted ChargeAmount | 36419.4 |
| Total Drug Medicare AllowedAmount | 17087.71 |
| Total Drug Medicare PaymentAmount | 13299.81 |
| Total Drug Medicare Standardized Payment Amount | 13299.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 6407 |
| Number Of Medicare Beneficiaries With Medical Services | 1553 |
| Total Medical Submitted Charge Amount | 461200 |
| Total Medical Medicare Allowed Amount | 294182.4 |
| Total Medical Medicare Payment Amount | 205416.96 |
| Total Medical Medicare Standardized Payment Amount | 222707.61 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 387 |
| Number Of Beneficiaries Age 65 to 74 | 519 |
| Number Of Beneficiaries Age 75 to 84 | 417 |
| Number Of Beneficiaries Age Greater 84 | 231 |
| Number Of Female Beneficiaries | 932 |
| Number Of Male Beneficiaries | 622 |
| Number Of Non Hispanic White Beneficiaries | 1430 |
| Number Of Black or African American Beneficiaries | 113 |
| 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 | 958 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 596 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5157 |