| National Provider Identifier [NPI]: | 1386881928 |
| Last Name Of The Provider | RA |
| First Name Of The Provider | DANIEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 KINGS HWY S |
| Street Address 2 Of The Provider | BUILDING 5 |
| City Of The Provider | CHERRY HILL |
| Zip Code Of The Provider | 080342500 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 3130 |
| Number Of Medicare Beneficiaries | 763 |
| Total Submitted Charge Amount | 712321.5 |
| Total Medicare Allowed Amount | 396321.02 |
| Total Medicare Payment Amount | 308882.95 |
| Total Medicare Standardized Payment Amount | 293184.68 |
| Drug Suppress Indicator | * |
| Number Of HCPCS Associated With Drug Services | |
| Number Of Drug Services | |
| Number Of Medicare Beneficiaries With Drug Services | |
| Total Drug Submitted ChargeAmount | |
| Total Drug Medicare AllowedAmount | |
| Total Drug Medicare PaymentAmount | |
| Total Drug Medicare Standardized Payment Amount | |
| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
| Number Of Medical Services | |
| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Total Medical Medicare Standardized Payment Amount | |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 258 |
| Number Of Beneficiaries Age 65 to 74 | 213 |
| Number Of Beneficiaries Age 75 to 84 | 174 |
| Number Of Beneficiaries Age Greater 84 | 118 |
| Number Of Female Beneficiaries | 338 |
| Number Of Male Beneficiaries | 425 |
| Number Of Non Hispanic White Beneficiaries | 408 |
| Number Of Black or African American Beneficiaries | 265 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 510 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 253 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 70 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 67 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 5.616 |