| National Provider Identifier [NPI]: | 1700871803 |
| Last Name Of The Provider | DENMAN |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18345 SW ALEXANDER ST |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | ALOHA |
| Zip Code Of The Provider | 970063960 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 1776 |
| Number Of Medicare Beneficiaries | 348 |
| Total Submitted Charge Amount | 124929 |
| Total Medicare Allowed Amount | 94323.75 |
| Total Medicare Payment Amount | 64039.76 |
| Total Medicare Standardized Payment Amount | 63546.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 31 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 135 |
| Total Drug Medicare AllowedAmount | 56.34 |
| Total Drug Medicare PaymentAmount | 41.34 |
| Total Drug Medicare Standardized Payment Amount | 41.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 1745 |
| Number Of Medicare Beneficiaries With Medical Services | 348 |
| Total Medical Submitted Charge Amount | 124794 |
| Total Medical Medicare Allowed Amount | 94267.41 |
| Total Medical Medicare Payment Amount | 63998.42 |
| Total Medical Medicare Standardized Payment Amount | 63505.55 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 111 |
| Number Of Beneficiaries Age Greater 84 | 60 |
| Number Of Female Beneficiaries | 207 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 336 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 3 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9283 |