| National Provider Identifier [NPI]: | 1508893975 |
| Last Name Of The Provider | WHITMORE |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14506 W GRANITE VALLEY DR |
| Street Address 2 Of The Provider | #124 |
| City Of The Provider | SUN CITY WEST |
| Zip Code Of The Provider | 853756010 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 4602 |
| Number Of Medicare Beneficiaries | 893 |
| Total Submitted Charge Amount | 228330.68 |
| Total Medicare Allowed Amount | 222643.59 |
| Total Medicare Payment Amount | 159959.97 |
| Total Medicare Standardized Payment Amount | 160300.72 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 8718.5 |
| Total Drug Medicare AllowedAmount | 8636.89 |
| Total Drug Medicare PaymentAmount | 6771.24 |
| Total Drug Medicare Standardized Payment Amount | 6771.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 4567 |
| Number Of Medicare Beneficiaries With Medical Services | 893 |
| Total Medical Submitted Charge Amount | 219612.18 |
| Total Medical Medicare Allowed Amount | 214006.7 |
| Total Medical Medicare Payment Amount | 153188.73 |
| Total Medical Medicare Standardized Payment Amount | 153529.48 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 440 |
| Number Of Beneficiaries Age 75 to 84 | 324 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 603 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 861 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.941 |