| National Provider Identifier [NPI]: | 1205831005 |
| Last Name Of The Provider | ALTMAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11900 E 12 MILE RD |
| Street Address 2 Of The Provider | STE 201 |
| City Of The Provider | WARREN |
| Zip Code Of The Provider | 480933490 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 11939 |
| Number Of Medicare Beneficiaries | 1534 |
| Total Submitted Charge Amount | 1125588.27 |
| Total Medicare Allowed Amount | 712951.94 |
| Total Medicare Payment Amount | 536322.59 |
| Total Medicare Standardized Payment Amount | 508374.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 205 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 3019.73 |
| Total Drug Medicare AllowedAmount | 806.74 |
| Total Drug Medicare PaymentAmount | 605.25 |
| Total Drug Medicare Standardized Payment Amount | 605.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 11734 |
| Number Of Medicare Beneficiaries With Medical Services | 1534 |
| Total Medical Submitted Charge Amount | 1122568.54 |
| Total Medical Medicare Allowed Amount | 712145.2 |
| Total Medical Medicare Payment Amount | 535717.34 |
| Total Medical Medicare Standardized Payment Amount | 507769.69 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 553 |
| Number Of Beneficiaries Age 75 to 84 | 536 |
| Number Of Beneficiaries Age Greater 84 | 249 |
| Number Of Female Beneficiaries | 768 |
| Number Of Male Beneficiaries | 766 |
| Number Of Non Hispanic White Beneficiaries | 1400 |
| Number Of Black or African American Beneficiaries | 85 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1358 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 176 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3322 |