| National Provider Identifier [NPI]: | 1518957844 |
| Last Name Of The Provider | BLUMENTHAL |
| First Name Of The Provider | JEROME |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 WHITCHER ST NE |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300601155 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1274 |
| Number Of Medicare Beneficiaries | 339 |
| Total Submitted Charge Amount | 166378.87 |
| Total Medicare Allowed Amount | 82383.88 |
| Total Medicare Payment Amount | 53461.95 |
| Total Medicare Standardized Payment Amount | 53684.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 3735.87 |
| Total Drug Medicare AllowedAmount | 2122.86 |
| Total Drug Medicare PaymentAmount | 2080.31 |
| Total Drug Medicare Standardized Payment Amount | 2080.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 1203 |
| Number Of Medicare Beneficiaries With Medical Services | 339 |
| Total Medical Submitted Charge Amount | 162643 |
| Total Medical Medicare Allowed Amount | 80261.02 |
| Total Medical Medicare Payment Amount | 51381.64 |
| Total Medical Medicare Standardized Payment Amount | 51604.56 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 152 |
| Number Of Beneficiaries Age 75 to 84 | 143 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 190 |
| Number Of Non Hispanic White Beneficiaries | 319 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 6 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9677 |