| National Provider Identifier [NPI]: | 1154429074 |
| Last Name Of The Provider | SLOTAR |
| First Name Of The Provider | DYLAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 761 45TH AVE |
| Street Address 2 Of The Provider | STE 103 |
| City Of The Provider | MUNSTER |
| Zip Code Of The Provider | 463212893 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Infectious Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 31985 |
| Number Of Medicare Beneficiaries | 765 |
| Total Submitted Charge Amount | 783254.15 |
| Total Medicare Allowed Amount | 383281.61 |
| Total Medicare Payment Amount | 295241.33 |
| Total Medicare Standardized Payment Amount | 309383.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 28801 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 89332.97 |
| Total Drug Medicare AllowedAmount | 35932.28 |
| Total Drug Medicare PaymentAmount | 28156.01 |
| Total Drug Medicare Standardized Payment Amount | 28156.01 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 3184 |
| Number Of Medicare Beneficiaries With Medical Services | 765 |
| Total Medical Submitted Charge Amount | 693921.18 |
| Total Medical Medicare Allowed Amount | 347349.33 |
| Total Medical Medicare Payment Amount | 267085.32 |
| Total Medical Medicare Standardized Payment Amount | 281227.75 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 116 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 249 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 431 |
| Number Of Male Beneficiaries | 334 |
| Number Of Non Hispanic White Beneficiaries | 565 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 78 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 574 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 65 |
| Percent Of With Chronic Kidney Disease | 67 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 48 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 57 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 18 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 3.2284 |