| National Provider Identifier [NPI]: | 1689689473 |
| Last Name Of The Provider | ZELTSER |
| First Name Of The Provider | ILIA |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 919 CONESTOGA RD |
| Street Address 2 Of The Provider | BLDG. ONE, SUITE 300 |
| City Of The Provider | BRYN MAWR |
| Zip Code Of The Provider | 190101352 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 104 |
| Number Of Services | 7443 |
| Number Of Medicare Beneficiaries | 680 |
| Total Submitted Charge Amount | 1233326.26 |
| Total Medicare Allowed Amount | 370552.13 |
| Total Medicare Payment Amount | 282585.2 |
| Total Medicare Standardized Payment Amount | 271971.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 4142 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 297300.7 |
| Total Drug Medicare AllowedAmount | 103104.78 |
| Total Drug Medicare PaymentAmount | 80725.2 |
| Total Drug Medicare Standardized Payment Amount | 80725.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 3301 |
| Number Of Medicare Beneficiaries With Medical Services | 680 |
| Total Medical Submitted Charge Amount | 936025.56 |
| Total Medical Medicare Allowed Amount | 267447.35 |
| Total Medical Medicare Payment Amount | 201860 |
| Total Medical Medicare Standardized Payment Amount | 191245.81 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 356 |
| Number Of Beneficiaries Age 75 to 84 | 186 |
| Number Of Beneficiaries Age Greater 84 | 102 |
| Number Of Female Beneficiaries | 185 |
| Number Of Male Beneficiaries | 495 |
| Number Of Non Hispanic White Beneficiaries | 611 |
| Number Of Black or African American Beneficiaries | 28 |
| 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 | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 646 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 32 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2653 |