| National Provider Identifier [NPI]: | 1700830221 |
| Last Name Of The Provider | SLOMAN-MOLL |
| First Name Of The Provider | ERIK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10410 MEDICAL LOOP UNIT 4B |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAREDO |
| Zip Code Of The Provider | 780456612 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Otolaryngology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 5441 |
| Number Of Medicare Beneficiaries | 481 |
| Total Submitted Charge Amount | 567672 |
| Total Medicare Allowed Amount | 274286.82 |
| Total Medicare Payment Amount | 204479.08 |
| Total Medicare Standardized Payment Amount | 214466.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 500 |
| Total Drug Medicare AllowedAmount | 118.2 |
| Total Drug Medicare PaymentAmount | 108.38 |
| Total Drug Medicare Standardized Payment Amount | 108.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 5407 |
| Number Of Medicare Beneficiaries With Medical Services | 481 |
| Total Medical Submitted Charge Amount | 567172 |
| Total Medical Medicare Allowed Amount | 274168.62 |
| Total Medical Medicare Payment Amount | 204370.7 |
| Total Medical Medicare Standardized Payment Amount | 214358.5 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 125 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 277 |
| Number Of Male Beneficiaries | 204 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 422 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 301 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.6648 |