| National Provider Identifier [NPI]: | 1467435487 |
| Last Name Of The Provider | MOULSDALE |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 520 UPPER CHESAPEAKE DR |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | BEL AIR |
| Zip Code Of The Provider | 210144339 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 3049 |
| Number Of Medicare Beneficiaries | 677 |
| Total Submitted Charge Amount | 541226 |
| Total Medicare Allowed Amount | 255699.33 |
| Total Medicare Payment Amount | 191494.26 |
| Total Medicare Standardized Payment Amount | 187261.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 196 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 53900 |
| Total Drug Medicare AllowedAmount | 41717.59 |
| Total Drug Medicare PaymentAmount | 32290.5 |
| Total Drug Medicare Standardized Payment Amount | 32290.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 2853 |
| Number Of Medicare Beneficiaries With Medical Services | 677 |
| Total Medical Submitted Charge Amount | 487326 |
| Total Medical Medicare Allowed Amount | 213981.74 |
| Total Medical Medicare Payment Amount | 159203.76 |
| Total Medical Medicare Standardized Payment Amount | 154971.04 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 302 |
| Number Of Beneficiaries Age 75 to 84 | 244 |
| Number Of Beneficiaries Age Greater 84 | 88 |
| Number Of Female Beneficiaries | 149 |
| Number Of Male Beneficiaries | 528 |
| Number Of Non Hispanic White Beneficiaries | 626 |
| Number Of Black or African American Beneficiaries | 33 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 632 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2764 |