| National Provider Identifier [NPI]: | 1780646174 |
| Last Name Of The Provider | SCHWARTZ |
| First Name Of The Provider | STANLEY |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8381 RIVERWALK PARK BLVD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339198760 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 80 |
| Number Of Services | 18133 |
| Number Of Medicare Beneficiaries | 1785 |
| Total Submitted Charge Amount | 1573444 |
| Total Medicare Allowed Amount | 974219.98 |
| Total Medicare Payment Amount | 732446.88 |
| Total Medicare Standardized Payment Amount | 685485.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 98 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 11368 |
| Total Drug Medicare AllowedAmount | 10139.5 |
| Total Drug Medicare PaymentAmount | 7824.13 |
| Total Drug Medicare Standardized Payment Amount | 7824.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 18035 |
| Number Of Medicare Beneficiaries With Medical Services | 1785 |
| Total Medical Submitted Charge Amount | 1562076 |
| Total Medical Medicare Allowed Amount | 964080.48 |
| Total Medical Medicare Payment Amount | 724622.75 |
| Total Medical Medicare Standardized Payment Amount | 677661.83 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 731 |
| Number Of Beneficiaries Age 75 to 84 | 634 |
| Number Of Beneficiaries Age Greater 84 | 373 |
| Number Of Female Beneficiaries | 908 |
| Number Of Male Beneficiaries | 877 |
| Number Of Non Hispanic White Beneficiaries | 1736 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1735 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 50 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0566 |