| National Provider Identifier [NPI]: | 1992704290 |
| Last Name Of The Provider | LOGAN |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1910 N ARLINGTON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462185128 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 6668 |
| Number Of Medicare Beneficiaries | 871 |
| Total Submitted Charge Amount | 302183.94 |
| Total Medicare Allowed Amount | 288923.13 |
| Total Medicare Payment Amount | 207049.02 |
| Total Medicare Standardized Payment Amount | 280827.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 81 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 145.64 |
| Total Drug Medicare AllowedAmount | 109.21 |
| Total Drug Medicare PaymentAmount | 74.54 |
| Total Drug Medicare Standardized Payment Amount | 74.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 6587 |
| Number Of Medicare Beneficiaries With Medical Services | 871 |
| Total Medical Submitted Charge Amount | 302038.3 |
| Total Medical Medicare Allowed Amount | 288813.92 |
| Total Medical Medicare Payment Amount | 206974.48 |
| Total Medical Medicare Standardized Payment Amount | 280753.4 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 277 |
| Number Of Beneficiaries Age 75 to 84 | 342 |
| Number Of Beneficiaries Age Greater 84 | 210 |
| Number Of Female Beneficiaries | 440 |
| Number Of Male Beneficiaries | 431 |
| Number Of Non Hispanic White Beneficiaries | 823 |
| Number Of Black or African American Beneficiaries | 26 |
| 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 | 813 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0908 |