| National Provider Identifier [NPI]: | 1184622714 |
| Last Name Of The Provider | SOLIS |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 17 WELLS ST |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | WESTERLY |
| Zip Code Of The Provider | 028912923 |
| State Code Of The Provider | RI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 3839 |
| Number Of Medicare Beneficiaries | 1011 |
| Total Submitted Charge Amount | 553565.62 |
| Total Medicare Allowed Amount | 283959.15 |
| Total Medicare Payment Amount | 204122.77 |
| Total Medicare Standardized Payment Amount | 195691.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 157 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 1242.5 |
| Total Drug Medicare AllowedAmount | 281.13 |
| Total Drug Medicare PaymentAmount | 203.46 |
| Total Drug Medicare Standardized Payment Amount | 203.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 61 |
| Number Of Medical Services | 3682 |
| Number Of Medicare Beneficiaries With Medical Services | 1011 |
| Total Medical Submitted Charge Amount | 552323.12 |
| Total Medical Medicare Allowed Amount | 283678.02 |
| Total Medical Medicare Payment Amount | 203919.31 |
| Total Medical Medicare Standardized Payment Amount | 195487.97 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 455 |
| Number Of Beneficiaries Age 75 to 84 | 360 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 550 |
| Number Of Male Beneficiaries | 461 |
| Number Of Non Hispanic White Beneficiaries | 978 |
| 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 | 970 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.029 |