| National Provider Identifier [NPI]: | 1235103938 |
| Last Name Of The Provider | MCCORMICK |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 107 TOWN CENTER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | KING OF PRUSSIA |
| Zip Code Of The Provider | 194062330 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 58 |
| Number Of Services | 325 |
| Number Of Medicare Beneficiaries | 121 |
| Total Submitted Charge Amount | 68342.5 |
| Total Medicare Allowed Amount | 26772.83 |
| Total Medicare Payment Amount | 20068.08 |
| Total Medicare Standardized Payment Amount | 18891.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 50 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 1579.89 |
| Total Drug Medicare AllowedAmount | 59.18 |
| Total Drug Medicare PaymentAmount | 54.74 |
| Total Drug Medicare Standardized Payment Amount | 54.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 275 |
| Number Of Medicare Beneficiaries With Medical Services | 121 |
| Total Medical Submitted Charge Amount | 66762.61 |
| Total Medical Medicare Allowed Amount | 26713.65 |
| Total Medical Medicare Payment Amount | 20013.34 |
| Total Medical Medicare Standardized Payment Amount | 18837.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 60 |
| Number Of Beneficiaries Age 75 to 84 | 34 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 73 |
| Number Of Male Beneficiaries | 48 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9779 |