| National Provider Identifier [NPI]: | 1023056348 |
| Last Name Of The Provider | MAITIN |
| First Name Of The Provider | ELLEN |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7500 CENTRAL AVE |
| Street Address 2 Of The Provider | SUITE 108 |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191112430 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 10511 |
| Number Of Medicare Beneficiaries | 876 |
| Total Submitted Charge Amount | 798641 |
| Total Medicare Allowed Amount | 403832.53 |
| Total Medicare Payment Amount | 297563.91 |
| Total Medicare Standardized Payment Amount | 281305.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3515 |
| Number Of Medicare Beneficiaries With Drug Services | 568 |
| Total Drug Submitted ChargeAmount | 95374 |
| Total Drug Medicare AllowedAmount | 57972.62 |
| Total Drug Medicare PaymentAmount | 45138.09 |
| Total Drug Medicare Standardized Payment Amount | 45138.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 97 |
| Number Of Medical Services | 6996 |
| Number Of Medicare Beneficiaries With Medical Services | 876 |
| Total Medical Submitted Charge Amount | 703267 |
| Total Medical Medicare Allowed Amount | 345859.91 |
| Total Medical Medicare Payment Amount | 252425.82 |
| Total Medical Medicare Standardized Payment Amount | 236167.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 124 |
| Number Of Beneficiaries Age 65 to 74 | 356 |
| Number Of Beneficiaries Age 75 to 84 | 271 |
| Number Of Beneficiaries Age Greater 84 | 125 |
| Number Of Female Beneficiaries | 616 |
| Number Of Male Beneficiaries | 260 |
| Number Of Non Hispanic White Beneficiaries | 778 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 757 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 119 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1173 |