| National Provider Identifier [NPI]: | 1144394107 |
| Last Name Of The Provider | KISHEL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10710 CHARTER DR |
| Street Address 2 Of The Provider | SUITE 130 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 210443128 |
| 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 | 63 |
| Number Of Services | 4805 |
| Number Of Medicare Beneficiaries | 691 |
| Total Submitted Charge Amount | 400995.7 |
| Total Medicare Allowed Amount | 253666.97 |
| Total Medicare Payment Amount | 189216.38 |
| Total Medicare Standardized Payment Amount | 179870.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 2510 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 74528.7 |
| Total Drug Medicare AllowedAmount | 35976.58 |
| Total Drug Medicare PaymentAmount | 28205.62 |
| Total Drug Medicare Standardized Payment Amount | 28205.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 59 |
| Number Of Medical Services | 2295 |
| Number Of Medicare Beneficiaries With Medical Services | 691 |
| Total Medical Submitted Charge Amount | 326467 |
| Total Medical Medicare Allowed Amount | 217690.39 |
| Total Medical Medicare Payment Amount | 161010.76 |
| Total Medical Medicare Standardized Payment Amount | 151664.87 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 239 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 110 |
| Number Of Male Beneficiaries | 581 |
| Number Of Non Hispanic White Beneficiaries | 549 |
| Number Of Black or African American Beneficiaries | 91 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 661 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1512 |