| National Provider Identifier [NPI]: | 1215934146 |
| Last Name Of The Provider | COLUCCIELLO |
| First Name Of The Provider | MICHAEL |
| 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 | 509 S LENOLA RD |
| Street Address 2 Of The Provider | STE 11 |
| City Of The Provider | MOORESTOWN |
| Zip Code Of The Provider | 080571556 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 45 |
| Number Of Services | 18964 |
| Number Of Medicare Beneficiaries | 885 |
| Total Submitted Charge Amount | 4995350 |
| Total Medicare Allowed Amount | 2991443.22 |
| Total Medicare Payment Amount | 2318051.31 |
| Total Medicare Standardized Payment Amount | 2267422.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 9347 |
| Number Of Medicare Beneficiaries With Drug Services | 383 |
| Total Drug Submitted ChargeAmount | 2532270 |
| Total Drug Medicare AllowedAmount | 2136821.19 |
| Total Drug Medicare PaymentAmount | 1673933.93 |
| Total Drug Medicare Standardized Payment Amount | 1673933.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 9617 |
| Number Of Medicare Beneficiaries With Medical Services | 885 |
| Total Medical Submitted Charge Amount | 2463080 |
| Total Medical Medicare Allowed Amount | 854622.03 |
| Total Medical Medicare Payment Amount | 644117.38 |
| Total Medical Medicare Standardized Payment Amount | 593489.04 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 260 |
| Number Of Beneficiaries Age 75 to 84 | 304 |
| Number Of Beneficiaries Age Greater 84 | 280 |
| Number Of Female Beneficiaries | 541 |
| Number Of Male Beneficiaries | 344 |
| Number Of Non Hispanic White Beneficiaries | 778 |
| Number Of Black or African American Beneficiaries | 58 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 836 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.427 |