| National Provider Identifier [NPI]: | 1124057419 |
| Last Name Of The Provider | BIRNBAUM |
| First Name Of The Provider | ALAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 NAVARRE PL |
| Street Address 2 Of The Provider | SUITE 5570 |
| City Of The Provider | SOUTH BEND |
| Zip Code Of The Provider | 466011169 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 75980.4 |
| Number Of Medicare Beneficiaries | 686 |
| Total Submitted Charge Amount | 7298088.96 |
| Total Medicare Allowed Amount | 2498149 |
| Total Medicare Payment Amount | 1880948.86 |
| Total Medicare Standardized Payment Amount | 1899756.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 71300.4 |
| Number Of Medicare Beneficiaries With Drug Services | 500 |
| Total Drug Submitted ChargeAmount | 5998797.96 |
| Total Drug Medicare AllowedAmount | 2159435.99 |
| Total Drug Medicare PaymentAmount | 1632413.38 |
| Total Drug Medicare Standardized Payment Amount | 1632413.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 4680 |
| Number Of Medicare Beneficiaries With Medical Services | 686 |
| Total Medical Submitted Charge Amount | 1299291 |
| Total Medical Medicare Allowed Amount | 338713.01 |
| Total Medical Medicare Payment Amount | 248535.48 |
| Total Medical Medicare Standardized Payment Amount | 267342.84 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 217 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 514 |
| Number Of Male Beneficiaries | 172 |
| Number Of Non Hispanic White Beneficiaries | 630 |
| Number Of Black or African American Beneficiaries | 38 |
| 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 | 607 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 25 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.161 |