| National Provider Identifier [NPI]: | 1730176389 |
| Last Name Of The Provider | PORTER |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2910 N 3RD AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850134434 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurosurgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 948 |
| Number Of Medicare Beneficiaries | 366 |
| Total Submitted Charge Amount | 1650550 |
| Total Medicare Allowed Amount | 420056.64 |
| Total Medicare Payment Amount | 326027.94 |
| Total Medicare Standardized Payment Amount | 328678.21 |
| 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 | 87 |
| Number Of Medical Services | 948 |
| Number Of Medicare Beneficiaries With Medical Services | 366 |
| Total Medical Submitted Charge Amount | 1650550 |
| Total Medical Medicare Allowed Amount | 420056.64 |
| Total Medical Medicare Payment Amount | 326027.94 |
| Total Medical Medicare Standardized Payment Amount | 328678.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 205 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 319 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 73 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2819 |