| National Provider Identifier [NPI]: | 1174566483 |
| Last Name Of The Provider | HERSCHTHAL |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7421 NORTH UNIVERSITY DR |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | TAMARAC |
| Zip Code Of The Provider | 33321 |
| 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 | 34 |
| Number Of Services | 13184 |
| Number Of Medicare Beneficiaries | 791 |
| Total Submitted Charge Amount | 529755.55 |
| Total Medicare Allowed Amount | 438702.91 |
| Total Medicare Payment Amount | 324214.08 |
| Total Medicare Standardized Payment Amount | 309353.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 91 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 5860 |
| Total Drug Medicare AllowedAmount | 3826.47 |
| Total Drug Medicare PaymentAmount | 2882.57 |
| Total Drug Medicare Standardized Payment Amount | 2882.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 13093 |
| Number Of Medicare Beneficiaries With Medical Services | 791 |
| Total Medical Submitted Charge Amount | 523895.55 |
| Total Medical Medicare Allowed Amount | 434876.44 |
| Total Medical Medicare Payment Amount | 321331.51 |
| Total Medical Medicare Standardized Payment Amount | 306471.24 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 264 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 277 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 367 |
| Number Of Non Hispanic White Beneficiaries | 758 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 771 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3087 |