| National Provider Identifier [NPI]: | 1588662019 |
| Last Name Of The Provider | BLUMBERG |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3455 MAIN ST |
| Street Address 2 Of The Provider | SUITE 5 |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071147 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 8427 |
| Number Of Medicare Beneficiaries | 2212 |
| Total Submitted Charge Amount | 1229592 |
| Total Medicare Allowed Amount | 423661.62 |
| Total Medicare Payment Amount | 311470.46 |
| Total Medicare Standardized Payment Amount | 269518.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 4378 |
| Total Drug Medicare AllowedAmount | 4314.67 |
| Total Drug Medicare PaymentAmount | 3364.61 |
| Total Drug Medicare Standardized Payment Amount | 3364.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 8346 |
| Number Of Medicare Beneficiaries With Medical Services | 2212 |
| Total Medical Submitted Charge Amount | 1225214 |
| Total Medical Medicare Allowed Amount | 419346.95 |
| Total Medical Medicare Payment Amount | 308105.85 |
| Total Medical Medicare Standardized Payment Amount | 266153.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 814 |
| Number Of Beneficiaries Age 75 to 84 | 760 |
| Number Of Beneficiaries Age Greater 84 | 492 |
| Number Of Female Beneficiaries | 1095 |
| Number Of Male Beneficiaries | 1117 |
| Number Of Non Hispanic White Beneficiaries | 2115 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 45 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1970 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 242 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1436 |