| National Provider Identifier [NPI]: | 1316057748 |
| Last Name Of The Provider | HURLEY |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9301 N CENTRAL EXPY |
| Street Address 2 Of The Provider | SUITE 180 |
| City Of The Provider | DALLAS |
| Zip Code Of The Provider | 752310806 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 876 |
| Number Of Medicare Beneficiaries | 164 |
| Total Submitted Charge Amount | 95441 |
| Total Medicare Allowed Amount | 51498.66 |
| Total Medicare Payment Amount | 36625.78 |
| Total Medicare Standardized Payment Amount | 36178.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 18 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 2300 |
| Total Drug Medicare AllowedAmount | 2102.5 |
| Total Drug Medicare PaymentAmount | 1636.61 |
| Total Drug Medicare Standardized Payment Amount | 1636.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 858 |
| Number Of Medicare Beneficiaries With Medical Services | 164 |
| Total Medical Submitted Charge Amount | 93141 |
| Total Medical Medicare Allowed Amount | 49396.16 |
| Total Medical Medicare Payment Amount | 34989.17 |
| Total Medical Medicare Standardized Payment Amount | 34541.93 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 129 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | 151 |
| 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 | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 0 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8425 |