| National Provider Identifier [NPI]: | 1457354805 |
| Last Name Of The Provider | DUBOIS |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1838 GREENE TREE RD |
| Street Address 2 Of The Provider | STE 535 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212087104 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 4765 |
| Number Of Medicare Beneficiaries | 1300 |
| Total Submitted Charge Amount | 1106965.8 |
| Total Medicare Allowed Amount | 472788.76 |
| Total Medicare Payment Amount | 358766.5 |
| Total Medicare Standardized Payment Amount | 337552.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 8976 |
| Total Drug Medicare AllowedAmount | 2334.86 |
| Total Drug Medicare PaymentAmount | 1830.5 |
| Total Drug Medicare Standardized Payment Amount | 1830.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 4721 |
| Number Of Medicare Beneficiaries With Medical Services | 1300 |
| Total Medical Submitted Charge Amount | 1097989.8 |
| Total Medical Medicare Allowed Amount | 470453.9 |
| Total Medical Medicare Payment Amount | 356936 |
| Total Medical Medicare Standardized Payment Amount | 335722.46 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 465 |
| Number Of Beneficiaries Age 75 to 84 | 454 |
| Number Of Beneficiaries Age Greater 84 | 302 |
| Number Of Female Beneficiaries | 672 |
| Number Of Male Beneficiaries | 628 |
| Number Of Non Hispanic White Beneficiaries | 805 |
| Number Of Black or African American Beneficiaries | 455 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 21 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1052 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 248 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 74 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5664 |