| National Provider Identifier [NPI]: | 1982670998 |
| Last Name Of The Provider | CHAMPION |
| First Name Of The Provider | PAOLO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7777 SOUTHWEST FWY |
| Street Address 2 Of The Provider | # 1032 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770741802 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 3152 |
| Number Of Medicare Beneficiaries | 521 |
| Total Submitted Charge Amount | 238114.09 |
| Total Medicare Allowed Amount | 215160.75 |
| Total Medicare Payment Amount | 157518.74 |
| Total Medicare Standardized Payment Amount | 163828.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 227 |
| Number Of Medicare Beneficiaries With Drug Services | 27 |
| Total Drug Submitted ChargeAmount | 46694.93 |
| Total Drug Medicare AllowedAmount | 46664.88 |
| Total Drug Medicare PaymentAmount | 36257.09 |
| Total Drug Medicare Standardized Payment Amount | 36257.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 2925 |
| Number Of Medicare Beneficiaries With Medical Services | 521 |
| Total Medical Submitted Charge Amount | 191419.16 |
| Total Medical Medicare Allowed Amount | 168495.87 |
| Total Medical Medicare Payment Amount | 121261.65 |
| Total Medical Medicare Standardized Payment Amount | 127571.44 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 202 |
| Number Of Beneficiaries Age 75 to 84 | 201 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 146 |
| Number Of Male Beneficiaries | 375 |
| Number Of Non Hispanic White Beneficiaries | 356 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 90 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 426 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3937 |