| National Provider Identifier [NPI]: | 1720086523 |
| Last Name Of The Provider | CLEVELAND |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1225 S GEAR AVE |
| Street Address 2 Of The Provider | MERCY PLAZA, SUITE 252 |
| City Of The Provider | WEST BURLINGTON |
| Zip Code Of The Provider | 526551691 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 10589 |
| Number Of Medicare Beneficiaries | 2788 |
| Total Submitted Charge Amount | 1863971 |
| Total Medicare Allowed Amount | 799333 |
| Total Medicare Payment Amount | 568290.6 |
| Total Medicare Standardized Payment Amount | 600031.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 10589 |
| Number Of Medicare Beneficiaries With Medical Services | 2788 |
| Total Medical Submitted Charge Amount | 1863971 |
| Total Medical Medicare Allowed Amount | 799333 |
| Total Medical Medicare Payment Amount | 568290.6 |
| Total Medical Medicare Standardized Payment Amount | 600031.79 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 1173 |
| Number Of Beneficiaries Age 75 to 84 | 975 |
| Number Of Beneficiaries Age Greater 84 | 515 |
| Number Of Female Beneficiaries | 1343 |
| Number Of Male Beneficiaries | 1445 |
| Number Of Non Hispanic White Beneficiaries | 2752 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2634 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 154 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.925 |