| National Provider Identifier [NPI]: | 1144482373 |
| Last Name Of The Provider | MACIAS |
| First Name Of The Provider | EDGAR |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1290 E SPRUCE AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FRESNO |
| Zip Code Of The Provider | 937203371 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 13157 |
| Number Of Medicare Beneficiaries | 1881 |
| Total Submitted Charge Amount | 1841074 |
| Total Medicare Allowed Amount | 981335.16 |
| Total Medicare Payment Amount | 713908.08 |
| Total Medicare Standardized Payment Amount | 675642.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 501 |
| Number Of Medicare Beneficiaries With Drug Services | 214 |
| Total Drug Submitted ChargeAmount | 75330 |
| Total Drug Medicare AllowedAmount | 52843.69 |
| Total Drug Medicare PaymentAmount | 41065.1 |
| Total Drug Medicare Standardized Payment Amount | 41065.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 12656 |
| Number Of Medicare Beneficiaries With Medical Services | 1881 |
| Total Medical Submitted Charge Amount | 1765744 |
| Total Medical Medicare Allowed Amount | 928491.47 |
| Total Medical Medicare Payment Amount | 672842.98 |
| Total Medical Medicare Standardized Payment Amount | 634577.59 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 927 |
| Number Of Beneficiaries Age 75 to 84 | 603 |
| Number Of Beneficiaries Age Greater 84 | 318 |
| Number Of Female Beneficiaries | 944 |
| Number Of Male Beneficiaries | 937 |
| Number Of Non Hispanic White Beneficiaries | 1770 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1850 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 8 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8867 |