| National Provider Identifier [NPI]: | 1346260411 |
| Last Name Of The Provider | DEGROOT |
| First Name Of The Provider | HENRY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1165 S DORA ST |
| Street Address 2 Of The Provider | SUITE G-2 |
| City Of The Provider | UKIAH |
| Zip Code Of The Provider | 954828325 |
| 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 | 74 |
| Number Of Services | 7224 |
| Number Of Medicare Beneficiaries | 1364 |
| Total Submitted Charge Amount | 947508.12 |
| Total Medicare Allowed Amount | 593015.62 |
| Total Medicare Payment Amount | 432644.56 |
| Total Medicare Standardized Payment Amount | 406888.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 10249 |
| Total Drug Medicare AllowedAmount | 9618 |
| Total Drug Medicare PaymentAmount | 7287.84 |
| Total Drug Medicare Standardized Payment Amount | 7287.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 7183 |
| Number Of Medicare Beneficiaries With Medical Services | 1364 |
| Total Medical Submitted Charge Amount | 937259.12 |
| Total Medical Medicare Allowed Amount | 583397.62 |
| Total Medical Medicare Payment Amount | 425356.72 |
| Total Medical Medicare Standardized Payment Amount | 399600.27 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 716 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 184 |
| Number Of Female Beneficiaries | 707 |
| Number Of Male Beneficiaries | 657 |
| Number Of Non Hispanic White Beneficiaries | 1274 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1184 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 180 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9045 |