| National Provider Identifier [NPI]: | 1205893104 |
| Last Name Of The Provider | HURST |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 632 W 11TH ST |
| Street Address 2 Of The Provider | SUITE 119 |
| City Of The Provider | TRACY |
| Zip Code Of The Provider | 953763856 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 393 |
| Number Of Medicare Beneficiaries | 74 |
| Total Submitted Charge Amount | 54038 |
| Total Medicare Allowed Amount | 34309.59 |
| Total Medicare Payment Amount | 25393.78 |
| Total Medicare Standardized Payment Amount | 24534.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 1166 |
| Total Drug Medicare AllowedAmount | 436.9 |
| Total Drug Medicare PaymentAmount | 420.16 |
| Total Drug Medicare Standardized Payment Amount | 420.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 367 |
| Number Of Medicare Beneficiaries With Medical Services | 74 |
| Total Medical Submitted Charge Amount | 52872 |
| Total Medical Medicare Allowed Amount | 33872.69 |
| Total Medical Medicare Payment Amount | 24973.62 |
| Total Medical Medicare Standardized Payment Amount | 24113.87 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 38 |
| Number Of Beneficiaries Age 75 to 84 | 13 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 42 |
| Number Of Male Beneficiaries | 32 |
| Number Of Non Hispanic White Beneficiaries | 57 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 54 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4234 |