| National Provider Identifier [NPI]: | 1194825752 |
| Last Name Of The Provider | FISHMAN |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1551 BISHOP ST |
| Street Address 2 Of The Provider | SUITE 410 |
| City Of The Provider | SAN LUIS OBISPO |
| Zip Code Of The Provider | 934014635 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 5496 |
| Number Of Medicare Beneficiaries | 1068 |
| Total Submitted Charge Amount | 302559.65 |
| Total Medicare Allowed Amount | 274154.66 |
| Total Medicare Payment Amount | 191686.7 |
| Total Medicare Standardized Payment Amount | 178475.96 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
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| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 577 |
| Number Of Beneficiaries Age 75 to 84 | 333 |
| Number Of Beneficiaries Age Greater 84 | 136 |
| Number Of Female Beneficiaries | 500 |
| Number Of Male Beneficiaries | 568 |
| Number Of Non Hispanic White Beneficiaries | 1030 |
| 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 | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1055 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 17 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 48 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.7795 |