| National Provider Identifier [NPI]: | 1710171335 |
| Last Name Of The Provider | KAISER |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 SE OSCEOLA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | STUART |
| Zip Code Of The Provider | 349942227 |
| 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 | 90 |
| Number Of Services | 21060 |
| Number Of Medicare Beneficiaries | 2693 |
| Total Submitted Charge Amount | 1985755.34 |
| Total Medicare Allowed Amount | 1654601.34 |
| Total Medicare Payment Amount | 1249282.49 |
| Total Medicare Standardized Payment Amount | 1151215.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 164 |
| Total Drug Medicare AllowedAmount | 145.58 |
| Total Drug Medicare PaymentAmount | 114.2 |
| Total Drug Medicare Standardized Payment Amount | 114.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 20978 |
| Number Of Medicare Beneficiaries With Medical Services | 2693 |
| Total Medical Submitted Charge Amount | 1985591.34 |
| Total Medical Medicare Allowed Amount | 1654455.76 |
| Total Medical Medicare Payment Amount | 1249168.29 |
| Total Medical Medicare Standardized Payment Amount | 1151100.97 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 996 |
| Number Of Beneficiaries Age 75 to 84 | 1068 |
| Number Of Beneficiaries Age Greater 84 | 565 |
| Number Of Female Beneficiaries | 1380 |
| Number Of Male Beneficiaries | 1313 |
| Number Of Non Hispanic White Beneficiaries | 2593 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2645 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 48 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1064 |