| National Provider Identifier [NPI]: | 1922090224 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | KEITH |
| 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 | 970 JOE FRANK HARRIS PKWY SE |
| Street Address 2 Of The Provider | SUITE 330 |
| City Of The Provider | CARTERSVILLE |
| Zip Code Of The Provider | 301202159 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 10890 |
| Number Of Medicare Beneficiaries | 1732 |
| Total Submitted Charge Amount | 866385 |
| Total Medicare Allowed Amount | 540616.1 |
| Total Medicare Payment Amount | 387786.27 |
| Total Medicare Standardized Payment Amount | 406202.58 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 166 |
| Number Of Beneficiaries Age 65 to 74 | 771 |
| Number Of Beneficiaries Age 75 to 84 | 586 |
| Number Of Beneficiaries Age Greater 84 | 209 |
| Number Of Female Beneficiaries | 892 |
| Number Of Male Beneficiaries | 840 |
| Number Of Non Hispanic White Beneficiaries | 1606 |
| Number Of Black or African American Beneficiaries | 99 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1516 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 216 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9935 |