| National Provider Identifier [NPI]: | 1124083506 |
| Last Name Of The Provider | PILGRAM |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 210 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILIPSBURG |
| Zip Code Of The Provider | 168661948 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 2868 |
| Number Of Medicare Beneficiaries | 759 |
| Total Submitted Charge Amount | 303840 |
| Total Medicare Allowed Amount | 157202.54 |
| Total Medicare Payment Amount | 107851.8 |
| Total Medicare Standardized Payment Amount | 112975.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 15 |
| Number Of Drug Services | 806 |
| Number Of Medicare Beneficiaries With Drug Services | 248 |
| Total Drug Submitted ChargeAmount | 19717 |
| Total Drug Medicare AllowedAmount | 7150.91 |
| Total Drug Medicare PaymentAmount | 6456.43 |
| Total Drug Medicare Standardized Payment Amount | 6456.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 2062 |
| Number Of Medicare Beneficiaries With Medical Services | 759 |
| Total Medical Submitted Charge Amount | 284123 |
| Total Medical Medicare Allowed Amount | 150051.63 |
| Total Medical Medicare Payment Amount | 101395.37 |
| Total Medical Medicare Standardized Payment Amount | 106518.86 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 239 |
| Number Of Beneficiaries Age 65 to 74 | 276 |
| Number Of Beneficiaries Age 75 to 84 | 167 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 419 |
| Number Of Male Beneficiaries | 340 |
| Number Of Non Hispanic White Beneficiaries | 747 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 443 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 316 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2192 |