| National Provider Identifier [NPI]: | 1760665707 |
| Last Name Of The Provider | HINCKLEY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3725 W 4100 S |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEST VALLEY CITY |
| Zip Code Of The Provider | 841205530 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 4516 |
| Number Of Medicare Beneficiaries | 678 |
| Total Submitted Charge Amount | 1452771.24 |
| Total Medicare Allowed Amount | 605738.44 |
| Total Medicare Payment Amount | 460288.24 |
| Total Medicare Standardized Payment Amount | 465609.34 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 121 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 11033 |
| Total Drug Medicare AllowedAmount | 8797.31 |
| Total Drug Medicare PaymentAmount | 6478.19 |
| Total Drug Medicare Standardized Payment Amount | 6478.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 125 |
| Number Of Medical Services | 4395 |
| Number Of Medicare Beneficiaries With Medical Services | 677 |
| Total Medical Submitted Charge Amount | 1441738.24 |
| Total Medical Medicare Allowed Amount | 596941.13 |
| Total Medical Medicare Payment Amount | 453810.05 |
| Total Medical Medicare Standardized Payment Amount | 459131.15 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 326 |
| Number Of Beneficiaries Age 75 to 84 | 238 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 337 |
| Number Of Male Beneficiaries | 341 |
| Number Of Non Hispanic White Beneficiaries | 644 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 655 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9296 |