| National Provider Identifier [NPI]: | 1730103706 |
| Last Name Of The Provider | MEHALLO |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 925 CHESTNUT ST |
| Street Address 2 Of The Provider | 5TH FLOOR |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191074216 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 5698 |
| Number Of Medicare Beneficiaries | 985 |
| Total Submitted Charge Amount | 1103085 |
| Total Medicare Allowed Amount | 485093.85 |
| Total Medicare Payment Amount | 365883.6 |
| Total Medicare Standardized Payment Amount | 342367.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1940 |
| Number Of Medicare Beneficiaries With Drug Services | 581 |
| Total Drug Submitted ChargeAmount | 437489 |
| Total Drug Medicare AllowedAmount | 213241.3 |
| Total Drug Medicare PaymentAmount | 165705.59 |
| Total Drug Medicare Standardized Payment Amount | 165705.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3758 |
| Number Of Medicare Beneficiaries With Medical Services | 985 |
| Total Medical Submitted Charge Amount | 665596 |
| Total Medical Medicare Allowed Amount | 271852.55 |
| Total Medical Medicare Payment Amount | 200178.01 |
| Total Medical Medicare Standardized Payment Amount | 176662.02 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 98 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 630 |
| Number Of Male Beneficiaries | 355 |
| Number Of Non Hispanic White Beneficiaries | 852 |
| Number Of Black or African American Beneficiaries | 105 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 892 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.977 |