| National Provider Identifier [NPI]: | 1164457412 |
| Last Name Of The Provider | HEDRICK |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 500 VONDERBURG DRIVE |
| Street Address 2 Of The Provider | STE 115W |
| City Of The Provider | BRANDON |
| Zip Code Of The Provider | 335115969 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 11930 |
| Number Of Medicare Beneficiaries | 1501 |
| Total Submitted Charge Amount | 1540320 |
| Total Medicare Allowed Amount | 654128.66 |
| Total Medicare Payment Amount | 496902.47 |
| Total Medicare Standardized Payment Amount | 491486.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 113 |
| Number Of Medicare Beneficiaries With Drug Services | 76 |
| Total Drug Submitted ChargeAmount | 1590 |
| Total Drug Medicare AllowedAmount | 1130.68 |
| Total Drug Medicare PaymentAmount | 883.73 |
| Total Drug Medicare Standardized Payment Amount | 883.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 11817 |
| Number Of Medicare Beneficiaries With Medical Services | 1501 |
| Total Medical Submitted Charge Amount | 1538730 |
| Total Medical Medicare Allowed Amount | 652997.98 |
| Total Medical Medicare Payment Amount | 496018.74 |
| Total Medical Medicare Standardized Payment Amount | 490602.64 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 707 |
| Number Of Beneficiaries Age 75 to 84 | 568 |
| Number Of Beneficiaries Age Greater 84 | 194 |
| Number Of Female Beneficiaries | 695 |
| Number Of Male Beneficiaries | 806 |
| Number Of Non Hispanic White Beneficiaries | 1416 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1472 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0355 |