| National Provider Identifier [NPI]: | 1871557348 |
| Last Name Of The Provider | STANFORD |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8573 COUNTY ROAD 64 |
| Street Address 2 Of The Provider | |
| City Of The Provider | DAPHNE |
| Zip Code Of The Provider | 365268706 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 10053 |
| Number Of Medicare Beneficiaries | 1624 |
| Total Submitted Charge Amount | 610568.1 |
| Total Medicare Allowed Amount | 545967.9 |
| Total Medicare Payment Amount | 390715.51 |
| Total Medicare Standardized Payment Amount | 425984.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 18634.28 |
| Total Drug Medicare AllowedAmount | 18269.74 |
| Total Drug Medicare PaymentAmount | 12738.57 |
| Total Drug Medicare Standardized Payment Amount | 12738.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 9952 |
| Number Of Medicare Beneficiaries With Medical Services | 1624 |
| Total Medical Submitted Charge Amount | 591933.82 |
| Total Medical Medicare Allowed Amount | 527698.16 |
| Total Medical Medicare Payment Amount | 377976.94 |
| Total Medical Medicare Standardized Payment Amount | 413246.03 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 785 |
| Number Of Beneficiaries Age 75 to 84 | 568 |
| Number Of Beneficiaries Age Greater 84 | 192 |
| Number Of Female Beneficiaries | 727 |
| Number Of Male Beneficiaries | 897 |
| Number Of Non Hispanic White Beneficiaries | 1576 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1579 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8976 |