| National Provider Identifier [NPI]: | 1689600439 |
| Last Name Of The Provider | EHRNSTROM |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3841 PIPER STREET |
| Street Address 2 Of The Provider | SUITE T4-020 |
| City Of The Provider | ANCHORAGE |
| Zip Code Of The Provider | 99508 |
| State Code Of The Provider | AK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 5547 |
| Number Of Medicare Beneficiaries | 1026 |
| Total Submitted Charge Amount | 854940 |
| Total Medicare Allowed Amount | 699576.36 |
| Total Medicare Payment Amount | 515159.26 |
| Total Medicare Standardized Payment Amount | 428037.02 |
| 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 | 74 |
| Number Of Medical Services | 5547 |
| Number Of Medicare Beneficiaries With Medical Services | 1026 |
| Total Medical Submitted Charge Amount | 854940 |
| Total Medical Medicare Allowed Amount | 699576.36 |
| Total Medical Medicare Payment Amount | 515159.26 |
| Total Medical Medicare Standardized Payment Amount | 428037.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 492 |
| Number Of Beneficiaries Age 75 to 84 | 360 |
| Number Of Beneficiaries Age Greater 84 | 143 |
| Number Of Female Beneficiaries | 470 |
| Number Of Male Beneficiaries | 556 |
| Number Of Non Hispanic White Beneficiaries | 951 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 967 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.8546 |