| National Provider Identifier [NPI]: | 1336124221 |
| Last Name Of The Provider | FEDGCHIN |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2422 S BROAD ST |
| Street Address 2 Of The Provider | 1ST FLOOR |
| City Of The Provider | PHILA |
| Zip Code Of The Provider | 191454418 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 2970 |
| Number Of Medicare Beneficiaries | 978 |
| Total Submitted Charge Amount | 534060 |
| Total Medicare Allowed Amount | 267380.66 |
| Total Medicare Payment Amount | 207015.24 |
| Total Medicare Standardized Payment Amount | 189610.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 283 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 10760 |
| Total Drug Medicare AllowedAmount | 2722.74 |
| Total Drug Medicare PaymentAmount | 2134.19 |
| Total Drug Medicare Standardized Payment Amount | 2134.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2687 |
| Number Of Medicare Beneficiaries With Medical Services | 978 |
| Total Medical Submitted Charge Amount | 523300 |
| Total Medical Medicare Allowed Amount | 264657.92 |
| Total Medical Medicare Payment Amount | 204881.05 |
| Total Medical Medicare Standardized Payment Amount | 187476.51 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 206 |
| Number Of Beneficiaries Age 65 to 74 | 343 |
| Number Of Beneficiaries Age 75 to 84 | 269 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 505 |
| Number Of Male Beneficiaries | 473 |
| Number Of Non Hispanic White Beneficiaries | 659 |
| Number Of Black or African American Beneficiaries | 250 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 621 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 357 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 54 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.4242 |