| National Provider Identifier [NPI]: | 1154448652 |
| Last Name Of The Provider | BAILEY |
| First Name Of The Provider | EVANS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 STONEGATE TRL |
| Street Address 2 Of The Provider | SUITE 112 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352422246 |
| 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 | 91 |
| Number Of Services | 6799 |
| Number Of Medicare Beneficiaries | 1269 |
| Total Submitted Charge Amount | 2491544.91 |
| Total Medicare Allowed Amount | 1570629.79 |
| Total Medicare Payment Amount | 1206362.7 |
| Total Medicare Standardized Payment Amount | 1299698.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 1275.6 |
| Total Drug Medicare AllowedAmount | 1271.47 |
| Total Drug Medicare PaymentAmount | 993.96 |
| Total Drug Medicare Standardized Payment Amount | 993.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 89 |
| Number Of Medical Services | 6773 |
| Number Of Medicare Beneficiaries With Medical Services | 1269 |
| Total Medical Submitted Charge Amount | 2490269.31 |
| Total Medical Medicare Allowed Amount | 1569358.32 |
| Total Medical Medicare Payment Amount | 1205368.74 |
| Total Medical Medicare Standardized Payment Amount | 1298704.61 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 502 |
| Number Of Beneficiaries Age 75 to 84 | 505 |
| Number Of Beneficiaries Age Greater 84 | 223 |
| Number Of Female Beneficiaries | 502 |
| Number Of Male Beneficiaries | 767 |
| Number Of Non Hispanic White Beneficiaries | 1251 |
| 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 | 1212 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0303 |