| National Provider Identifier [NPI]: | 1427051184 |
| Last Name Of The Provider | ERTL |
| First Name Of The Provider | GREGORY |
| 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 | 350 W CATALINA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | YUMA |
| Zip Code Of The Provider | 853648112 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 7588 |
| Number Of Medicare Beneficiaries | 1766 |
| Total Submitted Charge Amount | 904072.5 |
| Total Medicare Allowed Amount | 522319.11 |
| Total Medicare Payment Amount | 370195.3 |
| Total Medicare Standardized Payment Amount | 373004.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 244 |
| Number Of Medicare Beneficiaries With Drug Services | 54 |
| Total Drug Submitted ChargeAmount | 13712.5 |
| Total Drug Medicare AllowedAmount | 12452.79 |
| Total Drug Medicare PaymentAmount | 9719.98 |
| Total Drug Medicare Standardized Payment Amount | 9719.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 75 |
| Number Of Medical Services | 7344 |
| Number Of Medicare Beneficiaries With Medical Services | 1766 |
| Total Medical Submitted Charge Amount | 890360 |
| Total Medical Medicare Allowed Amount | 509866.32 |
| Total Medical Medicare Payment Amount | 360475.32 |
| Total Medical Medicare Standardized Payment Amount | 363284.89 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 678 |
| Number Of Beneficiaries Age 75 to 84 | 783 |
| Number Of Beneficiaries Age Greater 84 | 276 |
| Number Of Female Beneficiaries | 913 |
| Number Of Male Beneficiaries | 853 |
| Number Of Non Hispanic White Beneficiaries | 1670 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1732 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0436 |