| National Provider Identifier [NPI]: | 1720009525 |
| Last Name Of The Provider | MAISEL |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 SO OYSTER BAY RD |
| Street Address 2 Of The Provider | STE 305 |
| City Of The Provider | HICKSVILLE |
| Zip Code Of The Provider | 11801 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 15732 |
| Number Of Medicare Beneficiaries | 915 |
| Total Submitted Charge Amount | 12365060.39 |
| Total Medicare Allowed Amount | 4428302.48 |
| Total Medicare Payment Amount | 3446229.34 |
| Total Medicare Standardized Payment Amount | 3312071.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 6012 |
| Number Of Medicare Beneficiaries With Drug Services | 318 |
| Total Drug Submitted ChargeAmount | 6015799.58 |
| Total Drug Medicare AllowedAmount | 3142577.29 |
| Total Drug Medicare PaymentAmount | 2460407.85 |
| Total Drug Medicare Standardized Payment Amount | 2460407.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 9720 |
| Number Of Medicare Beneficiaries With Medical Services | 915 |
| Total Medical Submitted Charge Amount | 6349260.81 |
| Total Medical Medicare Allowed Amount | 1285725.19 |
| Total Medical Medicare Payment Amount | 985821.49 |
| Total Medical Medicare Standardized Payment Amount | 851663.82 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 47 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 295 |
| Number Of Beneficiaries Age Greater 84 | 285 |
| Number Of Female Beneficiaries | 546 |
| Number Of Male Beneficiaries | 369 |
| Number Of Non Hispanic White Beneficiaries | 835 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 839 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 76 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4579 |