| National Provider Identifier [NPI]: | 1881681971 |
| Last Name Of The Provider | ERMOLOVICH |
| First Name Of The Provider | TANYA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1259 S CEDAR CREST BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | ALLENTOWN |
| Zip Code Of The Provider | 181036206 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 3039 |
| Number Of Medicare Beneficiaries | 833 |
| Total Submitted Charge Amount | 255696 |
| Total Medicare Allowed Amount | 190317.54 |
| Total Medicare Payment Amount | 133593.41 |
| Total Medicare Standardized Payment Amount | 138885.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 3039 |
| Number Of Medicare Beneficiaries With Medical Services | 833 |
| Total Medical Submitted Charge Amount | 255696 |
| Total Medical Medicare Allowed Amount | 190317.54 |
| Total Medical Medicare Payment Amount | 133593.41 |
| Total Medical Medicare Standardized Payment Amount | 138885.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 434 |
| Number Of Beneficiaries Age 75 to 84 | 267 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 631 |
| Number Of Male Beneficiaries | 202 |
| Number Of Non Hispanic White Beneficiaries | 818 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 800 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.966 |