| National Provider Identifier [NPI]: | 1821047705 |
| Last Name Of The Provider | HART |
| First Name Of The Provider | ROLAND |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2545 W HAMMER LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | STOCKTON |
| Zip Code Of The Provider | 952092839 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 6935 |
| Number Of Medicare Beneficiaries | 1379 |
| Total Submitted Charge Amount | 1194712.8 |
| Total Medicare Allowed Amount | 397980.2 |
| Total Medicare Payment Amount | 279808.7 |
| Total Medicare Standardized Payment Amount | 264035.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 191 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 764 |
| Total Drug Medicare AllowedAmount | 341 |
| Total Drug Medicare PaymentAmount | 253.14 |
| Total Drug Medicare Standardized Payment Amount | 253.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 6744 |
| Number Of Medicare Beneficiaries With Medical Services | 1379 |
| Total Medical Submitted Charge Amount | 1193948.8 |
| Total Medical Medicare Allowed Amount | 397639.2 |
| Total Medical Medicare Payment Amount | 279555.56 |
| Total Medical Medicare Standardized Payment Amount | 263782.42 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 123 |
| Number Of Beneficiaries Age 65 to 74 | 622 |
| Number Of Beneficiaries Age 75 to 84 | 432 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 783 |
| Number Of Male Beneficiaries | 596 |
| Number Of Non Hispanic White Beneficiaries | 1118 |
| Number Of Black or African American Beneficiaries | 79 |
| Number Of AsianPacific Islander Beneficiaries | 64 |
| Number Of Hispanic Beneficiaries | 86 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1167 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 212 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9948 |