| National Provider Identifier [NPI]: | 1699721654 |
| Last Name Of The Provider | NIVATPUMIN |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9114 PHILADELPHIA RD |
| Street Address 2 Of The Provider | SUITE 208 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212374317 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 18306 |
| Number Of Medicare Beneficiaries | 697 |
| Total Submitted Charge Amount | 749670 |
| Total Medicare Allowed Amount | 427293.93 |
| Total Medicare Payment Amount | 330914.23 |
| Total Medicare Standardized Payment Amount | 326451.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 30 |
| Number Of Drug Services | 15372 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 408041 |
| Total Drug Medicare AllowedAmount | 255944.69 |
| Total Drug Medicare PaymentAmount | 200196.79 |
| Total Drug Medicare Standardized Payment Amount | 200196.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 2934 |
| Number Of Medicare Beneficiaries With Medical Services | 697 |
| Total Medical Submitted Charge Amount | 341629 |
| Total Medical Medicare Allowed Amount | 171349.24 |
| Total Medical Medicare Payment Amount | 130717.44 |
| Total Medical Medicare Standardized Payment Amount | 126254.91 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 318 |
| Number Of Beneficiaries Age 75 to 84 | 218 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 407 |
| Number Of Male Beneficiaries | 290 |
| Number Of Non Hispanic White Beneficiaries | 618 |
| Number Of Black or African American Beneficiaries | 62 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 601 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 96 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 37 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9397 |