| National Provider Identifier [NPI]: | 1760485619 |
| Last Name Of The Provider | TALLMAN |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2294 GRANT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BILLINGS |
| Zip Code Of The Provider | 591027423 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 7900 |
| Number Of Medicare Beneficiaries | 1499 |
| Total Submitted Charge Amount | 1933923.25 |
| Total Medicare Allowed Amount | 831737.21 |
| Total Medicare Payment Amount | 622633.74 |
| Total Medicare Standardized Payment Amount | 592004.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 55 |
| Total Drug Medicare AllowedAmount | 39.34 |
| Total Drug Medicare PaymentAmount | 30.84 |
| Total Drug Medicare Standardized Payment Amount | 30.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 7878 |
| Number Of Medicare Beneficiaries With Medical Services | 1499 |
| Total Medical Submitted Charge Amount | 1933868.25 |
| Total Medical Medicare Allowed Amount | 831697.87 |
| Total Medical Medicare Payment Amount | 622602.9 |
| Total Medical Medicare Standardized Payment Amount | 591973.51 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 610 |
| Number Of Beneficiaries Age 75 to 84 | 594 |
| Number Of Beneficiaries Age Greater 84 | 259 |
| Number Of Female Beneficiaries | 734 |
| Number Of Male Beneficiaries | 765 |
| Number Of Non Hispanic White Beneficiaries | 1461 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1426 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 73 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8617 |