| National Provider Identifier [NPI]: | 1760480842 |
| Last Name Of The Provider | FARISS |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3714 N ROOSEVELT BLVD |
| Street Address 2 Of The Provider | SUITE 640 |
| City Of The Provider | KEY WEST |
| Zip Code Of The Provider | 330404533 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 2891 |
| Number Of Medicare Beneficiaries | 475 |
| Total Submitted Charge Amount | 809054.64 |
| Total Medicare Allowed Amount | 254762.07 |
| Total Medicare Payment Amount | 190338.28 |
| Total Medicare Standardized Payment Amount | 177870.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 358 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 104359.13 |
| Total Drug Medicare AllowedAmount | 39640.17 |
| Total Drug Medicare PaymentAmount | 30926.68 |
| Total Drug Medicare Standardized Payment Amount | 30926.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 2533 |
| Number Of Medicare Beneficiaries With Medical Services | 475 |
| Total Medical Submitted Charge Amount | 704695.51 |
| Total Medical Medicare Allowed Amount | 215121.9 |
| Total Medical Medicare Payment Amount | 159411.6 |
| Total Medical Medicare Standardized Payment Amount | 146944.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 247 |
| Number Of Beneficiaries Age 75 to 84 | 149 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 335 |
| Number Of Non Hispanic White Beneficiaries | 394 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 56 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 412 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1417 |