| National Provider Identifier [NPI]: | 1356334965 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | REAGAN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8580 SCARBOROUGH DR |
| Street Address 2 Of The Provider | SUITE 225 |
| City Of The Provider | COLORADO SPRINGS |
| Zip Code Of The Provider | 809207586 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 11918 |
| Number Of Medicare Beneficiaries | 1011 |
| Total Submitted Charge Amount | 1827833.22 |
| Total Medicare Allowed Amount | 1036284.61 |
| Total Medicare Payment Amount | 786316.32 |
| Total Medicare Standardized Payment Amount | 741121.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 58.14 |
| Total Drug Medicare AllowedAmount | 37.53 |
| Total Drug Medicare PaymentAmount | 26.57 |
| Total Drug Medicare Standardized Payment Amount | 26.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 11897 |
| Number Of Medicare Beneficiaries With Medical Services | 1011 |
| Total Medical Submitted Charge Amount | 1827775.08 |
| Total Medical Medicare Allowed Amount | 1036247.08 |
| Total Medical Medicare Payment Amount | 786289.75 |
| Total Medical Medicare Standardized Payment Amount | 741094.56 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 556 |
| Number Of Beneficiaries Age 75 to 84 | 292 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 459 |
| Number Of Male Beneficiaries | 552 |
| Number Of Non Hispanic White Beneficiaries | 942 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 25 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 986 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 25 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9276 |