| National Provider Identifier [NPI]: | 1215976105 |
| Last Name Of The Provider | SOLIS |
| First Name Of The Provider | MAURICE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2409 N PATTERSON ST |
| Street Address 2 Of The Provider | SUITE 230 |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316022512 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 172 |
| Number Of Services | 5281 |
| Number Of Medicare Beneficiaries | 662 |
| Total Submitted Charge Amount | 1296009.15 |
| Total Medicare Allowed Amount | 262134.67 |
| Total Medicare Payment Amount | 195736.75 |
| Total Medicare Standardized Payment Amount | 209509.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 3665 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 10995 |
| Total Drug Medicare AllowedAmount | 633.31 |
| Total Drug Medicare PaymentAmount | 425.17 |
| Total Drug Medicare Standardized Payment Amount | 425.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 171 |
| Number Of Medical Services | 1616 |
| Number Of Medicare Beneficiaries With Medical Services | 662 |
| Total Medical Submitted Charge Amount | 1285014.15 |
| Total Medical Medicare Allowed Amount | 261501.36 |
| Total Medical Medicare Payment Amount | 195311.58 |
| Total Medical Medicare Standardized Payment Amount | 209084.19 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 245 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 290 |
| Number Of Male Beneficiaries | 372 |
| Number Of Non Hispanic White Beneficiaries | 512 |
| Number Of Black or African American Beneficiaries | 138 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 535 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 127 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.2946 |