| National Provider Identifier [NPI]: | 1639175409 |
| Last Name Of The Provider | BLUMENSTRAUCH |
| First Name Of The Provider | ROY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4201 TORRANCE BLVD |
| Street Address 2 Of The Provider | STE 640 |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905034504 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 20589 |
| Number Of Medicare Beneficiaries | 1584 |
| Total Submitted Charge Amount | 1314372.4 |
| Total Medicare Allowed Amount | 1071204.98 |
| Total Medicare Payment Amount | 784097.16 |
| Total Medicare Standardized Payment Amount | 698971.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 246 |
| Number Of Medicare Beneficiaries With Drug Services | 87 |
| Total Drug Submitted ChargeAmount | 10402.38 |
| Total Drug Medicare AllowedAmount | 4274.57 |
| Total Drug Medicare PaymentAmount | 3323.43 |
| Total Drug Medicare Standardized Payment Amount | 3323.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 20343 |
| Number Of Medicare Beneficiaries With Medical Services | 1584 |
| Total Medical Submitted Charge Amount | 1303970.02 |
| Total Medical Medicare Allowed Amount | 1066930.41 |
| Total Medical Medicare Payment Amount | 780773.73 |
| Total Medical Medicare Standardized Payment Amount | 695648.24 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 742 |
| Number Of Beneficiaries Age 75 to 84 | 523 |
| Number Of Beneficiaries Age Greater 84 | 232 |
| Number Of Female Beneficiaries | 882 |
| Number Of Male Beneficiaries | 702 |
| Number Of Non Hispanic White Beneficiaries | 1331 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 81 |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1424 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 160 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9882 |