| National Provider Identifier [NPI]: | 1881798064 |
| Last Name Of The Provider | WELCH |
| First Name Of The Provider | JUSTIN |
| 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 | 401 KEENE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652016625 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 91 |
| Number Of Services | 8381 |
| Number Of Medicare Beneficiaries | 1344 |
| Total Submitted Charge Amount | 991193 |
| Total Medicare Allowed Amount | 445347.35 |
| Total Medicare Payment Amount | 321524.95 |
| Total Medicare Standardized Payment Amount | 347497.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 59 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 13020 |
| Total Drug Medicare AllowedAmount | 10348.98 |
| Total Drug Medicare PaymentAmount | 8086.42 |
| Total Drug Medicare Standardized Payment Amount | 8086.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 8322 |
| Number Of Medicare Beneficiaries With Medical Services | 1344 |
| Total Medical Submitted Charge Amount | 978173 |
| Total Medical Medicare Allowed Amount | 434998.37 |
| Total Medical Medicare Payment Amount | 313438.53 |
| Total Medical Medicare Standardized Payment Amount | 339411.37 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 652 |
| Number Of Beneficiaries Age 75 to 84 | 439 |
| Number Of Beneficiaries Age Greater 84 | 179 |
| Number Of Female Beneficiaries | 686 |
| Number Of Male Beneficiaries | 658 |
| Number Of Non Hispanic White Beneficiaries | 1315 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9202 |