| National Provider Identifier [NPI]: | 1407845779 |
| Last Name Of The Provider | POULTON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9101 FRANKLIN SQUARE DR |
| Street Address 2 Of The Provider | SUITE 308 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212373936 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 10784 |
| Number Of Medicare Beneficiaries | 1931 |
| Total Submitted Charge Amount | 1144284 |
| Total Medicare Allowed Amount | 670483.94 |
| Total Medicare Payment Amount | 488632.39 |
| Total Medicare Standardized Payment Amount | 448106.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 84 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 9810 |
| Total Drug Medicare AllowedAmount | 7515 |
| Total Drug Medicare PaymentAmount | 5882.96 |
| Total Drug Medicare Standardized Payment Amount | 5882.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 10700 |
| Number Of Medicare Beneficiaries With Medical Services | 1931 |
| Total Medical Submitted Charge Amount | 1134474 |
| Total Medical Medicare Allowed Amount | 662968.94 |
| Total Medical Medicare Payment Amount | 482749.43 |
| Total Medical Medicare Standardized Payment Amount | 442223.93 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 121 |
| Number Of Beneficiaries Age 65 to 74 | 850 |
| Number Of Beneficiaries Age 75 to 84 | 662 |
| Number Of Beneficiaries Age Greater 84 | 298 |
| Number Of Female Beneficiaries | 1016 |
| Number Of Male Beneficiaries | 915 |
| Number Of Non Hispanic White Beneficiaries | 1857 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1851 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0504 |