| National Provider Identifier [NPI]: | 1720393218 |
| Last Name Of The Provider | STOLLMAN |
| First Name Of The Provider | NACHUM |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 132 S 10TH ST |
| Street Address 2 Of The Provider | MAIN BUILDING |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191075244 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 4894 |
| Number Of Medicare Beneficiaries | 2601 |
| Total Submitted Charge Amount | 1209654.6 |
| Total Medicare Allowed Amount | 268285.17 |
| Total Medicare Payment Amount | 207909.87 |
| Total Medicare Standardized Payment Amount | 199481.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1075 |
| Number Of Medicare Beneficiaries With Drug Services | 107 |
| Total Drug Submitted ChargeAmount | 9417.6 |
| Total Drug Medicare AllowedAmount | 3006.91 |
| Total Drug Medicare PaymentAmount | 2357.36 |
| Total Drug Medicare Standardized Payment Amount | 2357.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 3819 |
| Number Of Medicare Beneficiaries With Medical Services | 2600 |
| Total Medical Submitted Charge Amount | 1200237 |
| Total Medical Medicare Allowed Amount | 265278.26 |
| Total Medical Medicare Payment Amount | 205552.51 |
| Total Medical Medicare Standardized Payment Amount | 197123.93 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 253 |
| Number Of Beneficiaries Age 65 to 74 | 902 |
| Number Of Beneficiaries Age 75 to 84 | 767 |
| Number Of Beneficiaries Age Greater 84 | 679 |
| Number Of Female Beneficiaries | 1518 |
| Number Of Male Beneficiaries | 1083 |
| Number Of Non Hispanic White Beneficiaries | 2211 |
| Number Of Black or African American Beneficiaries | 288 |
| Number Of AsianPacific Islander Beneficiaries | 29 |
| Number Of Hispanic Beneficiaries | 21 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2251 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 350 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9426 |