| National Provider Identifier [NPI]: | 1215033501 |
| Last Name Of The Provider | HARRIS |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 50 N MEDICAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALT LAKE CITY |
| Zip Code Of The Provider | 841321100 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 15299 |
| Number Of Medicare Beneficiaries | 1965 |
| Total Submitted Charge Amount | 1214921.35 |
| Total Medicare Allowed Amount | 878961.09 |
| Total Medicare Payment Amount | 640501.1 |
| Total Medicare Standardized Payment Amount | 637959.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 162 |
| Number Of Medicare Beneficiaries With Drug Services | 117 |
| Total Drug Submitted ChargeAmount | 37456.25 |
| Total Drug Medicare AllowedAmount | 29529.56 |
| Total Drug Medicare PaymentAmount | 22918.06 |
| Total Drug Medicare Standardized Payment Amount | 22918.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 15137 |
| Number Of Medicare Beneficiaries With Medical Services | 1964 |
| Total Medical Submitted Charge Amount | 1177465.1 |
| Total Medical Medicare Allowed Amount | 849431.53 |
| Total Medical Medicare Payment Amount | 617583.04 |
| Total Medical Medicare Standardized Payment Amount | 615040.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 66 |
| Number Of Beneficiaries Age 65 to 74 | 878 |
| Number Of Beneficiaries Age 75 to 84 | 771 |
| Number Of Beneficiaries Age Greater 84 | 250 |
| Number Of Female Beneficiaries | 950 |
| Number Of Male Beneficiaries | 1015 |
| Number Of Non Hispanic White Beneficiaries | 1821 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 101 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1876 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 89 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0533 |