| National Provider Identifier [NPI]: | 1255359733 |
| Last Name Of The Provider | APPLEGARTH |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 505 SILHAVY RD |
| Street Address 2 Of The Provider | SUITE 800 |
| City Of The Provider | VALPARAISO |
| Zip Code Of The Provider | 463834460 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 10057 |
| Number Of Medicare Beneficiaries | 1751 |
| Total Submitted Charge Amount | 1572765 |
| Total Medicare Allowed Amount | 625829.1 |
| Total Medicare Payment Amount | 458580.99 |
| Total Medicare Standardized Payment Amount | 452480.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 172 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 43251 |
| Total Drug Medicare AllowedAmount | 37000.62 |
| Total Drug Medicare PaymentAmount | 27967.25 |
| Total Drug Medicare Standardized Payment Amount | 27967.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 9885 |
| Number Of Medicare Beneficiaries With Medical Services | 1735 |
| Total Medical Submitted Charge Amount | 1529514 |
| Total Medical Medicare Allowed Amount | 588828.48 |
| Total Medical Medicare Payment Amount | 430613.74 |
| Total Medical Medicare Standardized Payment Amount | 424513.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 801 |
| Number Of Beneficiaries Age 75 to 84 | 639 |
| Number Of Beneficiaries Age Greater 84 | 249 |
| Number Of Female Beneficiaries | 842 |
| Number Of Male Beneficiaries | 909 |
| Number Of Non Hispanic White Beneficiaries | 1712 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1694 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0108 |