| National Provider Identifier [NPI]: | 1194799429 |
| Last Name Of The Provider | MCLEAN |
| First Name Of The Provider | GWENDELLYN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2022 BROOKWOOD MEDICAL CENTER DR |
| Street Address 2 Of The Provider | SUITE 409 ACC |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 35209 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 4024 |
| Number Of Medicare Beneficiaries | 689 |
| Total Submitted Charge Amount | 208862 |
| Total Medicare Allowed Amount | 186961.79 |
| Total Medicare Payment Amount | 133716.09 |
| Total Medicare Standardized Payment Amount | 145921.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 6750 |
| Total Drug Medicare AllowedAmount | 6637.27 |
| Total Drug Medicare PaymentAmount | 4939.25 |
| Total Drug Medicare Standardized Payment Amount | 4939.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 3997 |
| Number Of Medicare Beneficiaries With Medical Services | 689 |
| Total Medical Submitted Charge Amount | 202112 |
| Total Medical Medicare Allowed Amount | 180324.52 |
| Total Medical Medicare Payment Amount | 128776.84 |
| Total Medical Medicare Standardized Payment Amount | 140982.32 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 361 |
| Number Of Beneficiaries Age 75 to 84 | 216 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 370 |
| Number Of Male Beneficiaries | 319 |
| Number Of Non Hispanic White Beneficiaries | 648 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8661 |