| National Provider Identifier [NPI]: | 1598758336 |
| Last Name Of The Provider | HAERTER |
| First Name Of The Provider | CHARLTON |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9225 N 3RD ST |
| Street Address 2 Of The Provider | SUITE 304 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850202439 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 1255 |
| Number Of Medicare Beneficiaries | 397 |
| Total Submitted Charge Amount | 216000 |
| Total Medicare Allowed Amount | 151423.64 |
| Total Medicare Payment Amount | 118161.57 |
| Total Medicare Standardized Payment Amount | 119331.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 1255 |
| Number Of Medicare Beneficiaries With Medical Services | 397 |
| Total Medical Submitted Charge Amount | 216000 |
| Total Medical Medicare Allowed Amount | 151423.64 |
| Total Medical Medicare Payment Amount | 118161.57 |
| Total Medical Medicare Standardized Payment Amount | 119331.67 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 124 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 226 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 347 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 311 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.152 |