| National Provider Identifier [NPI]: | 1053337394 |
| Last Name Of The Provider | BLOOM |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3000 E FLETCHER AVE |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336134656 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiac Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 361 |
| Number Of Medicare Beneficiaries | 165 |
| Total Submitted Charge Amount | 368196.32 |
| Total Medicare Allowed Amount | 159135.65 |
| Total Medicare Payment Amount | 122831.87 |
| Total Medicare Standardized Payment Amount | 118825.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 361 |
| Number Of Medicare Beneficiaries With Medical Services | 165 |
| Total Medical Submitted Charge Amount | 368196.32 |
| Total Medical Medicare Allowed Amount | 159135.65 |
| Total Medical Medicare Payment Amount | 122831.87 |
| Total Medical Medicare Standardized Payment Amount | 118825.26 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 68 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 35 |
| Number Of Female Beneficiaries | 69 |
| Number Of Male Beneficiaries | 96 |
| Number Of Non Hispanic White Beneficiaries | 142 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 35 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.877 |