| National Provider Identifier [NPI]: | 1508986662 |
| Last Name Of The Provider | COREY |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 505 N. DIERS |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND ISLAND |
| Zip Code Of The Provider | 688034983 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 79 |
| Number Of Services | 9823 |
| Number Of Medicare Beneficiaries | 1348 |
| Total Submitted Charge Amount | 1102984 |
| Total Medicare Allowed Amount | 549233.66 |
| Total Medicare Payment Amount | 395837.35 |
| Total Medicare Standardized Payment Amount | 428678.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 142 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 710 |
| Total Drug Medicare AllowedAmount | 252.62 |
| Total Drug Medicare PaymentAmount | 185.32 |
| Total Drug Medicare Standardized Payment Amount | 185.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 9681 |
| Number Of Medicare Beneficiaries With Medical Services | 1348 |
| Total Medical Submitted Charge Amount | 1102274 |
| Total Medical Medicare Allowed Amount | 548981.04 |
| Total Medical Medicare Payment Amount | 395652.03 |
| Total Medical Medicare Standardized Payment Amount | 428493.53 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 577 |
| Number Of Beneficiaries Age 75 to 84 | 508 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 708 |
| Number Of Male Beneficiaries | 640 |
| Number Of Non Hispanic White Beneficiaries | 1333 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1263 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9392 |