| National Provider Identifier [NPI]: | 1114949492 |
| Last Name Of The Provider | DAULAT |
| First Name Of The Provider | JALDEEP |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1250 S BUFFALO DR |
| Street Address 2 Of The Provider | SUITE 170 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891178328 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 17694 |
| Number Of Medicare Beneficiaries | 2788 |
| Total Submitted Charge Amount | 3209254.16 |
| Total Medicare Allowed Amount | 1859064.91 |
| Total Medicare Payment Amount | 1388806.06 |
| Total Medicare Standardized Payment Amount | 1355182.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 299 |
| Number Of Medicare Beneficiaries With Drug Services | 156 |
| Total Drug Submitted ChargeAmount | 29725.5 |
| Total Drug Medicare AllowedAmount | 22478.01 |
| Total Drug Medicare PaymentAmount | 17504.52 |
| Total Drug Medicare Standardized Payment Amount | 17504.52 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 17395 |
| Number Of Medicare Beneficiaries With Medical Services | 2788 |
| Total Medical Submitted Charge Amount | 3179528.66 |
| Total Medical Medicare Allowed Amount | 1836586.9 |
| Total Medical Medicare Payment Amount | 1371301.54 |
| Total Medical Medicare Standardized Payment Amount | 1337678.05 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 150 |
| Number Of Beneficiaries Age 65 to 74 | 1347 |
| Number Of Beneficiaries Age 75 to 84 | 1034 |
| Number Of Beneficiaries Age Greater 84 | 257 |
| Number Of Female Beneficiaries | 1215 |
| Number Of Male Beneficiaries | 1573 |
| Number Of Non Hispanic White Beneficiaries | 2613 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 59 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 40 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2613 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 175 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0278 |