| National Provider Identifier [NPI]: | 1790756138 |
| Last Name Of The Provider | CHASTAIN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 835 COGBURN AVE NW |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300601031 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 10589 |
| Number Of Medicare Beneficiaries | 1968 |
| Total Submitted Charge Amount | 6520044 |
| Total Medicare Allowed Amount | 2896375.38 |
| Total Medicare Payment Amount | 2237537.72 |
| Total Medicare Standardized Payment Amount | 2274267.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 297 |
| Number Of Medicare Beneficiaries With Drug Services | 183 |
| Total Drug Submitted ChargeAmount | 70405 |
| Total Drug Medicare AllowedAmount | 66038.49 |
| Total Drug Medicare PaymentAmount | 50902.14 |
| Total Drug Medicare Standardized Payment Amount | 50902.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 115 |
| Number Of Medical Services | 10292 |
| Number Of Medicare Beneficiaries With Medical Services | 1968 |
| Total Medical Submitted Charge Amount | 6449639 |
| Total Medical Medicare Allowed Amount | 2830336.89 |
| Total Medical Medicare Payment Amount | 2186635.58 |
| Total Medical Medicare Standardized Payment Amount | 2223365.81 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 81 |
| Number Of Beneficiaries Age 65 to 74 | 945 |
| Number Of Beneficiaries Age 75 to 84 | 672 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 802 |
| Number Of Male Beneficiaries | 1166 |
| Number Of Non Hispanic White Beneficiaries | 1886 |
| Number Of Black or African American Beneficiaries | 32 |
| 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 | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1882 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0922 |