| National Provider Identifier [NPI]: | 1134159627 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | LAWRENCE |
| 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 | 1367 DOMINION PLAZA |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757031013 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 7478 |
| Number Of Medicare Beneficiaries | 1334 |
| Total Submitted Charge Amount | 2507920.08 |
| Total Medicare Allowed Amount | 774083.82 |
| Total Medicare Payment Amount | 587414.28 |
| Total Medicare Standardized Payment Amount | 606585.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 460 |
| Number Of Medicare Beneficiaries With Drug Services | 67 |
| Total Drug Submitted ChargeAmount | 6824.57 |
| Total Drug Medicare AllowedAmount | 2336.46 |
| Total Drug Medicare PaymentAmount | 1740.23 |
| Total Drug Medicare Standardized Payment Amount | 1740.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 7018 |
| Number Of Medicare Beneficiaries With Medical Services | 1334 |
| Total Medical Submitted Charge Amount | 2501095.51 |
| Total Medical Medicare Allowed Amount | 771747.36 |
| Total Medical Medicare Payment Amount | 585674.05 |
| Total Medical Medicare Standardized Payment Amount | 604845.74 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 34 |
| Number Of Beneficiaries Age 65 to 74 | 449 |
| Number Of Beneficiaries Age 75 to 84 | 611 |
| Number Of Beneficiaries Age Greater 84 | 240 |
| Number Of Female Beneficiaries | 519 |
| Number Of Male Beneficiaries | 815 |
| Number Of Non Hispanic White Beneficiaries | 1312 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1280 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.09 |