| National Provider Identifier [NPI]: | 1770656332 |
| Last Name Of The Provider | MILLER |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3777 NORTH FRONTAGE ROAD |
| Street Address 2 Of The Provider | SUITE 900 |
| City Of The Provider | MICHIGAN CITY |
| Zip Code Of The Provider | 463607695 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 5393 |
| Number Of Medicare Beneficiaries | 521 |
| Total Submitted Charge Amount | 665446 |
| Total Medicare Allowed Amount | 240260.5 |
| Total Medicare Payment Amount | 175165.96 |
| Total Medicare Standardized Payment Amount | 189028.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2886 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 37301 |
| Total Drug Medicare AllowedAmount | 18060.08 |
| Total Drug Medicare PaymentAmount | 14105.39 |
| Total Drug Medicare Standardized Payment Amount | 14105.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2507 |
| Number Of Medicare Beneficiaries With Medical Services | 521 |
| Total Medical Submitted Charge Amount | 628145 |
| Total Medical Medicare Allowed Amount | 222200.42 |
| Total Medical Medicare Payment Amount | 161060.57 |
| Total Medical Medicare Standardized Payment Amount | 174923.46 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 241 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 32 |
| Number Of Female Beneficiaries | 310 |
| Number Of Male Beneficiaries | 211 |
| Number Of Non Hispanic White Beneficiaries | 475 |
| Number Of Black or African American Beneficiaries | 31 |
| 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 | 336 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 185 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3609 |