| National Provider Identifier [NPI]: | 1639373590 |
| Last Name Of The Provider | HELLER |
| First Name Of The Provider | JUSTIN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 42135 10TH ST W |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | LANCASTER |
| Zip Code Of The Provider | 935347095 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 201 |
| Number Of Services | 3491 |
| Number Of Medicare Beneficiaries | 323 |
| Total Submitted Charge Amount | 2197538 |
| Total Medicare Allowed Amount | 535301.7 |
| Total Medicare Payment Amount | 418148.68 |
| Total Medicare Standardized Payment Amount | 371577.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 949 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 9390 |
| Total Drug Medicare AllowedAmount | 1873.89 |
| Total Drug Medicare PaymentAmount | 1469.7 |
| Total Drug Medicare Standardized Payment Amount | 1469.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 198 |
| Number Of Medical Services | 2542 |
| Number Of Medicare Beneficiaries With Medical Services | 323 |
| Total Medical Submitted Charge Amount | 2188148 |
| Total Medical Medicare Allowed Amount | 533427.81 |
| Total Medical Medicare Payment Amount | 416678.98 |
| Total Medical Medicare Standardized Payment Amount | 370107.66 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 112 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 160 |
| Number Of Male Beneficiaries | 163 |
| Number Of Non Hispanic White Beneficiaries | 233 |
| Number Of Black or African American Beneficiaries | 39 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 194 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 129 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7297 |