| National Provider Identifier [NPI]: | 1114912466 |
| Last Name Of The Provider | SUAH |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 LAKEBRIDGE PLAZA DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORMOND BEACH |
| Zip Code Of The Provider | 321745157 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 14902 |
| Number Of Medicare Beneficiaries | 1921 |
| Total Submitted Charge Amount | 1648362.65 |
| Total Medicare Allowed Amount | 953884.83 |
| Total Medicare Payment Amount | 713480.36 |
| Total Medicare Standardized Payment Amount | 704254.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 207 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 7207.54 |
| Total Drug Medicare AllowedAmount | 6366.12 |
| Total Drug Medicare PaymentAmount | 4818.53 |
| Total Drug Medicare Standardized Payment Amount | 4818.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 14695 |
| Number Of Medicare Beneficiaries With Medical Services | 1919 |
| Total Medical Submitted Charge Amount | 1641155.11 |
| Total Medical Medicare Allowed Amount | 947518.71 |
| Total Medical Medicare Payment Amount | 708661.83 |
| Total Medical Medicare Standardized Payment Amount | 699435.52 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 867 |
| Number Of Beneficiaries Age 75 to 84 | 764 |
| Number Of Beneficiaries Age Greater 84 | 245 |
| Number Of Female Beneficiaries | 906 |
| Number Of Male Beneficiaries | 1015 |
| Number Of Non Hispanic White Beneficiaries | 1854 |
| Number Of Black or African American Beneficiaries | 29 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1884 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9713 |