| National Provider Identifier [NPI]: | 1265545396 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | KEITH |
| 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 | 9090 PARK ROYAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339089616 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 10992 |
| Number Of Medicare Beneficiaries | 2700 |
| Total Submitted Charge Amount | 1184495.45 |
| Total Medicare Allowed Amount | 1060250.99 |
| Total Medicare Payment Amount | 790546.73 |
| Total Medicare Standardized Payment Amount | 751041.19 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 338 |
| Number Of Medicare Beneficiaries With Drug Services | 239 |
| Total Drug Submitted ChargeAmount | 93369.12 |
| Total Drug Medicare AllowedAmount | 83665.22 |
| Total Drug Medicare PaymentAmount | 65514.35 |
| Total Drug Medicare Standardized Payment Amount | 65514.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 10654 |
| Number Of Medicare Beneficiaries With Medical Services | 2700 |
| Total Medical Submitted Charge Amount | 1091126.33 |
| Total Medical Medicare Allowed Amount | 976585.77 |
| Total Medical Medicare Payment Amount | 725032.38 |
| Total Medical Medicare Standardized Payment Amount | 685526.84 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 1179 |
| Number Of Beneficiaries Age 75 to 84 | 1138 |
| Number Of Beneficiaries Age Greater 84 | 357 |
| Number Of Female Beneficiaries | 1283 |
| Number Of Male Beneficiaries | 1417 |
| Number Of Non Hispanic White Beneficiaries | 2644 |
| 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 | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2679 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9548 |