| National Provider Identifier [NPI]: | 1578788659 |
| Last Name Of The Provider | WARTMAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3455 MAIN ST |
| Street Address 2 Of The Provider | STE. # 5 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071142 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 8773 |
| Number Of Medicare Beneficiaries | 2501 |
| Total Submitted Charge Amount | 1335092 |
| Total Medicare Allowed Amount | 422280.44 |
| Total Medicare Payment Amount | 312984.36 |
| Total Medicare Standardized Payment Amount | 262847.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 8508 |
| Total Drug Medicare AllowedAmount | 8381.31 |
| Total Drug Medicare PaymentAmount | 6540.38 |
| Total Drug Medicare Standardized Payment Amount | 6540.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 8735 |
| Number Of Medicare Beneficiaries With Medical Services | 2501 |
| Total Medical Submitted Charge Amount | 1326584 |
| Total Medical Medicare Allowed Amount | 413899.13 |
| Total Medical Medicare Payment Amount | 306443.98 |
| Total Medical Medicare Standardized Payment Amount | 256306.85 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 928 |
| Number Of Beneficiaries Age 75 to 84 | 857 |
| Number Of Beneficiaries Age Greater 84 | 552 |
| Number Of Female Beneficiaries | 1225 |
| Number Of Male Beneficiaries | 1276 |
| Number Of Non Hispanic White Beneficiaries | 2400 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 272 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0965 |