| National Provider Identifier [NPI]: | 1821046772 |
| Last Name Of The Provider | MACKEY |
| First Name Of The Provider | VERNON |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9191 W THUNDERBIRD RD |
| Street Address 2 Of The Provider | D-101 |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 853814270 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 4706 |
| Number Of Medicare Beneficiaries | 601 |
| Total Submitted Charge Amount | 512229 |
| Total Medicare Allowed Amount | 358874.66 |
| Total Medicare Payment Amount | 272948.43 |
| Total Medicare Standardized Payment Amount | 271187.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 107 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 4060 |
| Total Drug Medicare AllowedAmount | 3603.88 |
| Total Drug Medicare PaymentAmount | 2803.08 |
| Total Drug Medicare Standardized Payment Amount | 2803.08 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 4599 |
| Number Of Medicare Beneficiaries With Medical Services | 601 |
| Total Medical Submitted Charge Amount | 508169 |
| Total Medical Medicare Allowed Amount | 355270.78 |
| Total Medical Medicare Payment Amount | 270145.35 |
| Total Medical Medicare Standardized Payment Amount | 268383.94 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 332 |
| Number Of Beneficiaries Age 75 to 84 | 158 |
| Number Of Beneficiaries Age Greater 84 | 71 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 554 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 542 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1307 |