| National Provider Identifier [NPI]: | 1265691232 |
| Last Name Of The Provider | HYATT |
| First Name Of The Provider | ANN-MARIE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8103 CLEARVISTA PARKWAY |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 46256 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 5148 |
| Number Of Medicare Beneficiaries | 1970 |
| Total Submitted Charge Amount | 701355 |
| Total Medicare Allowed Amount | 365903.96 |
| Total Medicare Payment Amount | 267821.61 |
| Total Medicare Standardized Payment Amount | 264511.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 75 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 450 |
| Total Drug Medicare AllowedAmount | 133.85 |
| Total Drug Medicare PaymentAmount | 86.34 |
| Total Drug Medicare Standardized Payment Amount | 86.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 5073 |
| Number Of Medicare Beneficiaries With Medical Services | 1970 |
| Total Medical Submitted Charge Amount | 700905 |
| Total Medical Medicare Allowed Amount | 365770.11 |
| Total Medical Medicare Payment Amount | 267735.27 |
| Total Medical Medicare Standardized Payment Amount | 264425.28 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 186 |
| Number Of Beneficiaries Age 65 to 74 | 957 |
| Number Of Beneficiaries Age 75 to 84 | 552 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 1088 |
| Number Of Male Beneficiaries | 882 |
| Number Of Non Hispanic White Beneficiaries | 1852 |
| Number Of Black or African American Beneficiaries | 71 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1758 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0799 |