| National Provider Identifier [NPI]: | 1821066291 |
| Last Name Of The Provider | SAMEL |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 152 EMORY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATTLEBORO |
| Zip Code Of The Provider | 027032434 |
| 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 | 74 |
| Number Of Services | 5206 |
| Number Of Medicare Beneficiaries | 1221 |
| Total Submitted Charge Amount | 560291.4 |
| Total Medicare Allowed Amount | 307133.35 |
| Total Medicare Payment Amount | 220164.56 |
| Total Medicare Standardized Payment Amount | 208288.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 49 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 2110 |
| Total Drug Medicare AllowedAmount | 1537.25 |
| Total Drug Medicare PaymentAmount | 1198.09 |
| Total Drug Medicare Standardized Payment Amount | 1198.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 72 |
| Number Of Medical Services | 5157 |
| Number Of Medicare Beneficiaries With Medical Services | 1221 |
| Total Medical Submitted Charge Amount | 558181.4 |
| Total Medical Medicare Allowed Amount | 305596.1 |
| Total Medical Medicare Payment Amount | 218966.47 |
| Total Medical Medicare Standardized Payment Amount | 207090.85 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 526 |
| Number Of Beneficiaries Age 75 to 84 | 441 |
| Number Of Beneficiaries Age Greater 84 | 207 |
| Number Of Female Beneficiaries | 596 |
| Number Of Male Beneficiaries | 625 |
| Number Of Non Hispanic White Beneficiaries | 1188 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1163 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9723 |