| National Provider Identifier [NPI]: | 1225011786 |
| Last Name Of The Provider | GROSSMAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 COULTER AVE |
| Street Address 2 Of The Provider | SUITE 109 |
| City Of The Provider | ARDMORE |
| Zip Code Of The Provider | 190032418 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 106 |
| Number Of Services | 6399 |
| Number Of Medicare Beneficiaries | 974 |
| Total Submitted Charge Amount | 657509 |
| Total Medicare Allowed Amount | 381994.36 |
| Total Medicare Payment Amount | 297741.47 |
| Total Medicare Standardized Payment Amount | 279732.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 119 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 1499 |
| Total Drug Medicare AllowedAmount | 1027.3 |
| Total Drug Medicare PaymentAmount | 801.05 |
| Total Drug Medicare Standardized Payment Amount | 801.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 103 |
| Number Of Medical Services | 6280 |
| Number Of Medicare Beneficiaries With Medical Services | 974 |
| Total Medical Submitted Charge Amount | 656010 |
| Total Medical Medicare Allowed Amount | 380967.06 |
| Total Medical Medicare Payment Amount | 296940.42 |
| Total Medical Medicare Standardized Payment Amount | 278931.23 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 305 |
| Number Of Beneficiaries Age 75 to 84 | 291 |
| Number Of Beneficiaries Age Greater 84 | 268 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 410 |
| Number Of Non Hispanic White Beneficiaries | 732 |
| Number Of Black or African American Beneficiaries | 216 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 783 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 191 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0521 |