| National Provider Identifier [NPI]: | 1700834041 |
| Last Name Of The Provider | BLOOMGARDEN |
| First Name Of The Provider | RAPHAEL |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1722 BETHLEHEM PIKE |
| Street Address 2 Of The Provider | CHESTNUT HILL CARDIOLOGY LTD |
| City Of The Provider | FLOURTOWN |
| Zip Code Of The Provider | 190311644 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 3673 |
| Number Of Medicare Beneficiaries | 1141 |
| Total Submitted Charge Amount | 601153 |
| Total Medicare Allowed Amount | 295972.59 |
| Total Medicare Payment Amount | 219069.49 |
| Total Medicare Standardized Payment Amount | 202412.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 119 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 3570 |
| Total Drug Medicare AllowedAmount | 97 |
| Total Drug Medicare PaymentAmount | 75.99 |
| Total Drug Medicare Standardized Payment Amount | 75.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 3554 |
| Number Of Medicare Beneficiaries With Medical Services | 1141 |
| Total Medical Submitted Charge Amount | 597583 |
| Total Medical Medicare Allowed Amount | 295875.59 |
| Total Medical Medicare Payment Amount | 218993.5 |
| Total Medical Medicare Standardized Payment Amount | 202336.36 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 394 |
| Number Of Beneficiaries Age 75 to 84 | 351 |
| Number Of Beneficiaries Age Greater 84 | 297 |
| Number Of Female Beneficiaries | 621 |
| Number Of Male Beneficiaries | 520 |
| Number Of Non Hispanic White Beneficiaries | 648 |
| Number Of Black or African American Beneficiaries | 464 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 901 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 240 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8784 |