| National Provider Identifier [NPI]: | 1033101647 |
| Last Name Of The Provider | MEISENHEIMER |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7300 SANDLAKE COMMONS BLVD |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328198050 |
| 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 | 68 |
| Number Of Services | 10806 |
| Number Of Medicare Beneficiaries | 1134 |
| Total Submitted Charge Amount | 2362477.7 |
| Total Medicare Allowed Amount | 1192459.71 |
| Total Medicare Payment Amount | 901974.87 |
| Total Medicare Standardized Payment Amount | 878066 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 8084.7 |
| Total Drug Medicare AllowedAmount | 7105.28 |
| Total Drug Medicare PaymentAmount | 5364.47 |
| Total Drug Medicare Standardized Payment Amount | 5364.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 10749 |
| Number Of Medicare Beneficiaries With Medical Services | 1134 |
| Total Medical Submitted Charge Amount | 2354393 |
| Total Medical Medicare Allowed Amount | 1185354.43 |
| Total Medical Medicare Payment Amount | 896610.4 |
| Total Medical Medicare Standardized Payment Amount | 872701.53 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 438 |
| Number Of Beneficiaries Age 75 to 84 | 489 |
| Number Of Beneficiaries Age Greater 84 | 168 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 570 |
| Number Of Non Hispanic White Beneficiaries | 1040 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1100 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0481 |