| National Provider Identifier [NPI]: | 1063490472 |
| Last Name Of The Provider | BECK |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1367 DOMINION PLZ |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757031013 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 29001 |
| Number Of Medicare Beneficiaries | 1860 |
| Total Submitted Charge Amount | 1886192.28 |
| Total Medicare Allowed Amount | 1763069.44 |
| Total Medicare Payment Amount | 1297986.1 |
| Total Medicare Standardized Payment Amount | 1365236.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 169 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 30974.69 |
| Total Drug Medicare AllowedAmount | 30563.37 |
| Total Drug Medicare PaymentAmount | 22673.5 |
| Total Drug Medicare Standardized Payment Amount | 22673.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 96 |
| Number Of Medical Services | 28832 |
| Number Of Medicare Beneficiaries With Medical Services | 1860 |
| Total Medical Submitted Charge Amount | 1855217.59 |
| Total Medical Medicare Allowed Amount | 1732506.07 |
| Total Medical Medicare Payment Amount | 1275312.6 |
| Total Medical Medicare Standardized Payment Amount | 1342563.32 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 704 |
| Number Of Beneficiaries Age 75 to 84 | 776 |
| Number Of Beneficiaries Age Greater 84 | 350 |
| Number Of Female Beneficiaries | 673 |
| Number Of Male Beneficiaries | 1187 |
| Number Of Non Hispanic White Beneficiaries | 1835 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.041 |