| National Provider Identifier [NPI]: | 1568604668 |
| Last Name Of The Provider | MINER |
| First Name Of The Provider | ANDREW |
| 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 | 1286 FLORIDA AVE S |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKLEDGE |
| Zip Code Of The Provider | 329552484 |
| 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 | 63 |
| Number Of Services | 5154 |
| Number Of Medicare Beneficiaries | 1979 |
| Total Submitted Charge Amount | 394027 |
| Total Medicare Allowed Amount | 253343.28 |
| Total Medicare Payment Amount | 195046.57 |
| Total Medicare Standardized Payment Amount | 194672.2 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 2160 |
| Total Drug Medicare AllowedAmount | 1724.2 |
| Total Drug Medicare PaymentAmount | 1351.73 |
| Total Drug Medicare Standardized Payment Amount | 1351.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 5135 |
| Number Of Medicare Beneficiaries With Medical Services | 1979 |
| Total Medical Submitted Charge Amount | 391867 |
| Total Medical Medicare Allowed Amount | 251619.08 |
| Total Medical Medicare Payment Amount | 193694.84 |
| Total Medical Medicare Standardized Payment Amount | 193320.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 939 |
| Number Of Beneficiaries Age 75 to 84 | 720 |
| Number Of Beneficiaries Age Greater 84 | 241 |
| Number Of Female Beneficiaries | 901 |
| Number Of Male Beneficiaries | 1078 |
| Number Of Non Hispanic White Beneficiaries | 1911 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1920 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| 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 | 1.0779 |