| National Provider Identifier [NPI]: | 1336202407 |
| Last Name Of The Provider | CATIPON |
| First Name Of The Provider | ERICSON |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3001 SOUTH HANOVER ST., |
| Street Address 2 Of The Provider | GRUEHN BLDG. SUITE 300 |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 21225 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 1153 |
| Number Of Medicare Beneficiaries | 372 |
| Total Submitted Charge Amount | 154738 |
| Total Medicare Allowed Amount | 100162.98 |
| Total Medicare Payment Amount | 69392.15 |
| Total Medicare Standardized Payment Amount | 65959.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 1835 |
| Total Drug Medicare AllowedAmount | 1235.17 |
| Total Drug Medicare PaymentAmount | 1209.91 |
| Total Drug Medicare Standardized Payment Amount | 1209.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 1080 |
| Number Of Medicare Beneficiaries With Medical Services | 372 |
| Total Medical Submitted Charge Amount | 152903 |
| Total Medical Medicare Allowed Amount | 98927.81 |
| Total Medical Medicare Payment Amount | 68182.24 |
| Total Medical Medicare Standardized Payment Amount | 64750 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 148 |
| Number Of Beneficiaries Age 65 to 74 | 142 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | 193 |
| Number Of Black or African American Beneficiaries | 157 |
| 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 | 207 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 165 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.387 |