| National Provider Identifier [NPI]: | 1073549358 |
| Last Name Of The Provider | BIRNBAUM |
| First Name Of The Provider | ALLAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1701 SE HILLMOOR DR |
| Street Address 2 Of The Provider | SUITE #5 |
| City Of The Provider | PORT SAINT LUCIE |
| Zip Code Of The Provider | 349527552 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 43294 |
| Number Of Medicare Beneficiaries | 919 |
| Total Submitted Charge Amount | 1757201.85 |
| Total Medicare Allowed Amount | 1187938.1 |
| Total Medicare Payment Amount | 956086.18 |
| Total Medicare Standardized Payment Amount | 936617.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 9279 |
| Number Of Medicare Beneficiaries With Drug Services | 566 |
| Total Drug Submitted ChargeAmount | 207761 |
| Total Drug Medicare AllowedAmount | 149936.96 |
| Total Drug Medicare PaymentAmount | 121394.36 |
| Total Drug Medicare Standardized Payment Amount | 121394.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 34015 |
| Number Of Medicare Beneficiaries With Medical Services | 919 |
| Total Medical Submitted Charge Amount | 1549440.85 |
| Total Medical Medicare Allowed Amount | 1038001.14 |
| Total Medical Medicare Payment Amount | 834691.82 |
| Total Medical Medicare Standardized Payment Amount | 815223.13 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 344 |
| Number Of Beneficiaries Age 75 to 84 | 372 |
| Number Of Beneficiaries Age Greater 84 | 184 |
| Number Of Female Beneficiaries | 519 |
| Number Of Male Beneficiaries | 400 |
| Number Of Non Hispanic White Beneficiaries | 879 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 899 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 20 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4653 |