| National Provider Identifier [NPI]: | 1407050818 |
| Last Name Of The Provider | MAURO |
| First Name Of The Provider | KAIJA |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 11842 ROCK LANDING DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 236064437 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 6406 |
| Number Of Medicare Beneficiaries | 1438 |
| Total Submitted Charge Amount | 694399 |
| Total Medicare Allowed Amount | 413210.15 |
| Total Medicare Payment Amount | 301828.96 |
| Total Medicare Standardized Payment Amount | 305814 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 155 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 48756 |
| Total Drug Medicare AllowedAmount | 36358.88 |
| Total Drug Medicare PaymentAmount | 28100.38 |
| Total Drug Medicare Standardized Payment Amount | 28100.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 6251 |
| Number Of Medicare Beneficiaries With Medical Services | 1438 |
| Total Medical Submitted Charge Amount | 645643 |
| Total Medical Medicare Allowed Amount | 376851.27 |
| Total Medical Medicare Payment Amount | 273728.58 |
| Total Medical Medicare Standardized Payment Amount | 277713.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 885 |
| Number Of Beneficiaries Age 75 to 84 | 412 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 932 |
| Number Of Male Beneficiaries | 506 |
| Number Of Non Hispanic White Beneficiaries | 1344 |
| Number Of Black or African American Beneficiaries | 38 |
| 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 | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7686 |