| National Provider Identifier [NPI]: | 1750386124 |
| Last Name Of The Provider | BENESH |
| First Name Of The Provider | SAMUEL |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 QUARRY LAKE DRIVE |
| Street Address 2 Of The Provider | SUITE 350 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212090000 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1842 |
| Number Of Medicare Beneficiaries | 279 |
| Total Submitted Charge Amount | 140676 |
| Total Medicare Allowed Amount | 121866.61 |
| Total Medicare Payment Amount | 99843.19 |
| Total Medicare Standardized Payment Amount | 94721.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 287 |
| Number Of Medicare Beneficiaries With Drug Services | 203 |
| Total Drug Submitted ChargeAmount | 19663 |
| Total Drug Medicare AllowedAmount | 15828.48 |
| Total Drug Medicare PaymentAmount | 15451.33 |
| Total Drug Medicare Standardized Payment Amount | 15451.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1555 |
| Number Of Medicare Beneficiaries With Medical Services | 279 |
| Total Medical Submitted Charge Amount | 121013 |
| Total Medical Medicare Allowed Amount | 106038.13 |
| Total Medical Medicare Payment Amount | 84391.86 |
| Total Medical Medicare Standardized Payment Amount | 79270.42 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 163 |
| Number Of Male Beneficiaries | 116 |
| Number Of Non Hispanic White Beneficiaries | 247 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1309 |