| National Provider Identifier [NPI]: | 1508077801 |
| Last Name Of The Provider | MAILLER-SAVAGE |
| First Name Of The Provider | ERICA |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1933 DUNDEE DR |
| Street Address 2 Of The Provider | SUITE 307 |
| City Of The Provider | WINTER PARK |
| Zip Code Of The Provider | 327924103 |
| 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 | 54 |
| Number Of Services | 2269 |
| Number Of Medicare Beneficiaries | 802 |
| Total Submitted Charge Amount | 579176.35 |
| Total Medicare Allowed Amount | 362800.31 |
| Total Medicare Payment Amount | 266581.24 |
| Total Medicare Standardized Payment Amount | 262794.26 |
| 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 | 54 |
| Number Of Medical Services | 2269 |
| Number Of Medicare Beneficiaries With Medical Services | 802 |
| Total Medical Submitted Charge Amount | 579176.35 |
| Total Medical Medicare Allowed Amount | 362800.31 |
| Total Medical Medicare Payment Amount | 266581.24 |
| Total Medical Medicare Standardized Payment Amount | 262794.26 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 419 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 481 |
| Number Of Male Beneficiaries | 321 |
| Number Of Non Hispanic White Beneficiaries | 751 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 767 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9939 |