| National Provider Identifier [NPI]: | 1285693887 |
| Last Name Of The Provider | GOTTLIEB |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 GORDON DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | EXTON |
| Zip Code Of The Provider | 193411252 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 10895 |
| Number Of Medicare Beneficiaries | 2149 |
| Total Submitted Charge Amount | 1099553 |
| Total Medicare Allowed Amount | 599443.83 |
| Total Medicare Payment Amount | 438184.65 |
| Total Medicare Standardized Payment Amount | 392414.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 856 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 97458 |
| Total Drug Medicare AllowedAmount | 64955.69 |
| Total Drug Medicare PaymentAmount | 48156.28 |
| Total Drug Medicare Standardized Payment Amount | 48156.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 10039 |
| Number Of Medicare Beneficiaries With Medical Services | 2149 |
| Total Medical Submitted Charge Amount | 1002095 |
| Total Medical Medicare Allowed Amount | 534488.14 |
| Total Medical Medicare Payment Amount | 390028.37 |
| Total Medical Medicare Standardized Payment Amount | 344257.96 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 101 |
| Number Of Beneficiaries Age 65 to 74 | 1108 |
| Number Of Beneficiaries Age 75 to 84 | 638 |
| Number Of Beneficiaries Age Greater 84 | 302 |
| Number Of Female Beneficiaries | 1088 |
| Number Of Male Beneficiaries | 1061 |
| Number Of Non Hispanic White Beneficiaries | 2054 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2062 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9633 |