National Provider Identifier [NPI]: |
1154308872 |
Last Name Of The Provider |
METRO |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
9880 BUSTLETON AVE |
Street Address 2 Of The Provider |
SUITE 311 |
City Of The Provider |
PHILA |
Zip Code Of The Provider |
19115 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
135 |
Number Of Services |
6381 |
Number Of Medicare Beneficiaries |
605 |
Total Submitted Charge Amount |
901000 |
Total Medicare Allowed Amount |
422023.69 |
Total Medicare Payment Amount |
320040.06 |
Total Medicare Standardized Payment Amount |
310495.91 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
2804 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
205550 |
Total Drug Medicare AllowedAmount |
113127.75 |
Total Drug Medicare PaymentAmount |
88637.65 |
Total Drug Medicare Standardized Payment Amount |
88637.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
126 |
Number Of Medical Services |
3577 |
Number Of Medicare Beneficiaries With Medical Services |
605 |
Total Medical Submitted Charge Amount |
695450 |
Total Medical Medicare Allowed Amount |
308895.94 |
Total Medical Medicare Payment Amount |
231402.41 |
Total Medical Medicare Standardized Payment Amount |
221858.26 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
253 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
113 |
Number Of Male Beneficiaries |
492 |
Number Of Non Hispanic White Beneficiaries |
277 |
Number Of Black or African American Beneficiaries |
265 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
37 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
378 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
227 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
29 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.3643 |