| National Provider Identifier [NPI]: | 1114003415 |
| Last Name Of The Provider | ANTHONY |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 276 KINGSBURY GRADE |
| Street Address 2 Of The Provider | SUITE 101 B 5910 |
| City Of The Provider | STATELINE |
| Zip Code Of The Provider | 894499804 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 5954 |
| Number Of Medicare Beneficiaries | 770 |
| Total Submitted Charge Amount | 747225 |
| Total Medicare Allowed Amount | 412451.96 |
| Total Medicare Payment Amount | 314933.65 |
| Total Medicare Standardized Payment Amount | 293261.86 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 2780 |
| Total Drug Medicare AllowedAmount | 2291.94 |
| Total Drug Medicare PaymentAmount | 1796.88 |
| Total Drug Medicare Standardized Payment Amount | 1796.88 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 5913 |
| Number Of Medicare Beneficiaries With Medical Services | 770 |
| Total Medical Submitted Charge Amount | 744445 |
| Total Medical Medicare Allowed Amount | 410160.02 |
| Total Medical Medicare Payment Amount | 313136.77 |
| Total Medical Medicare Standardized Payment Amount | 291464.98 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 402 |
| Number Of Beneficiaries Age 75 to 84 | 243 |
| Number Of Beneficiaries Age Greater 84 | 84 |
| Number Of Female Beneficiaries | 385 |
| Number Of Male Beneficiaries | 385 |
| Number Of Non Hispanic White Beneficiaries | 730 |
| Number Of Black or African American Beneficiaries | |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 732 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8692 |