| National Provider Identifier [NPI]: | 1316969694 |
| Last Name Of The Provider | MICHAELS |
| First Name Of The Provider | JASON |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 51 LONG WHARF MALL |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT |
| Zip Code Of The Provider | 028402906 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 100 |
| Number Of Services | 9061 |
| Number Of Medicare Beneficiaries | 1315 |
| Total Submitted Charge Amount | 1161052.3 |
| Total Medicare Allowed Amount | 662869.61 |
| Total Medicare Payment Amount | 491983.32 |
| Total Medicare Standardized Payment Amount | 468407.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1825 |
| Total Drug Medicare AllowedAmount | 130.42 |
| Total Drug Medicare PaymentAmount | 92.32 |
| Total Drug Medicare Standardized Payment Amount | 92.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 8988 |
| Number Of Medicare Beneficiaries With Medical Services | 1315 |
| Total Medical Submitted Charge Amount | 1159227.3 |
| Total Medical Medicare Allowed Amount | 662739.19 |
| Total Medical Medicare Payment Amount | 491891 |
| Total Medical Medicare Standardized Payment Amount | 468315.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 607 |
| Number Of Beneficiaries Age 75 to 84 | 357 |
| Number Of Beneficiaries Age Greater 84 | 239 |
| Number Of Female Beneficiaries | 722 |
| Number Of Male Beneficiaries | 593 |
| Number Of Non Hispanic White Beneficiaries | 1247 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1210 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 105 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0599 |