| National Provider Identifier [NPI]: | 1841281532 |
| Last Name Of The Provider | DORMAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6330 ORCHARD LAKE RD |
| Street Address 2 Of The Provider | SUITE 120 |
| City Of The Provider | WEST BLOOMFIELD |
| Zip Code Of The Provider | 483222398 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 7458 |
| Number Of Medicare Beneficiaries | 2169 |
| Total Submitted Charge Amount | 815493 |
| Total Medicare Allowed Amount | 474097.18 |
| Total Medicare Payment Amount | 350545.56 |
| Total Medicare Standardized Payment Amount | 310597.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 720 |
| Total Drug Medicare AllowedAmount | 623.25 |
| Total Drug Medicare PaymentAmount | 484.23 |
| Total Drug Medicare Standardized Payment Amount | 484.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 7434 |
| Number Of Medicare Beneficiaries With Medical Services | 2169 |
| Total Medical Submitted Charge Amount | 814773 |
| Total Medical Medicare Allowed Amount | 473473.93 |
| Total Medical Medicare Payment Amount | 350061.33 |
| Total Medical Medicare Standardized Payment Amount | 310113.6 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 105 |
| Number Of Beneficiaries Age 65 to 74 | 1077 |
| Number Of Beneficiaries Age 75 to 84 | 658 |
| Number Of Beneficiaries Age Greater 84 | 329 |
| Number Of Female Beneficiaries | 1082 |
| Number Of Male Beneficiaries | 1087 |
| Number Of Non Hispanic White Beneficiaries | 2052 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 43 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2076 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0691 |