| National Provider Identifier [NPI]: | 1750492369 |
| Last Name Of The Provider | PUTMAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1874 BELTLINE RD SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 356015514 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 5196 |
| Number Of Medicare Beneficiaries | 1318 |
| Total Submitted Charge Amount | 800044 |
| Total Medicare Allowed Amount | 294110.29 |
| Total Medicare Payment Amount | 206306.36 |
| Total Medicare Standardized Payment Amount | 223435.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 195 |
| Number Of Medicare Beneficiaries With Drug Services | 176 |
| Total Drug Submitted ChargeAmount | 3064 |
| Total Drug Medicare AllowedAmount | 2495.98 |
| Total Drug Medicare PaymentAmount | 2428.06 |
| Total Drug Medicare Standardized Payment Amount | 2428.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 5001 |
| Number Of Medicare Beneficiaries With Medical Services | 1318 |
| Total Medical Submitted Charge Amount | 796980 |
| Total Medical Medicare Allowed Amount | 291614.31 |
| Total Medical Medicare Payment Amount | 203878.3 |
| Total Medical Medicare Standardized Payment Amount | 221007.28 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 366 |
| Number Of Beneficiaries Age 65 to 74 | 468 |
| Number Of Beneficiaries Age 75 to 84 | 343 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 760 |
| Number Of Male Beneficiaries | 558 |
| Number Of Non Hispanic White Beneficiaries | 1072 |
| Number Of Black or African American Beneficiaries | 234 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 899 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 419 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2281 |