| National Provider Identifier [NPI]: | 1790772705 |
| Last Name Of The Provider | PURCELL |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1259 S CEDAR CREST BLVD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | ALLENTOWN |
| Zip Code Of The Provider | 181036206 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 6842 |
| Number Of Medicare Beneficiaries | 1689 |
| Total Submitted Charge Amount | 603483.5 |
| Total Medicare Allowed Amount | 436729.47 |
| Total Medicare Payment Amount | 317443.36 |
| Total Medicare Standardized Payment Amount | 328776.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 178 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 402.5 |
| Total Drug Medicare AllowedAmount | 149.22 |
| Total Drug Medicare PaymentAmount | 117.07 |
| Total Drug Medicare Standardized Payment Amount | 117.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 6664 |
| Number Of Medicare Beneficiaries With Medical Services | 1689 |
| Total Medical Submitted Charge Amount | 603081 |
| Total Medical Medicare Allowed Amount | 436580.25 |
| Total Medical Medicare Payment Amount | 317326.29 |
| Total Medical Medicare Standardized Payment Amount | 328659.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 687 |
| Number Of Beneficiaries Age 75 to 84 | 625 |
| Number Of Beneficiaries Age Greater 84 | 285 |
| Number Of Female Beneficiaries | 842 |
| Number Of Male Beneficiaries | 847 |
| Number Of Non Hispanic White Beneficiaries | 1651 |
| Number Of Black or African American Beneficiaries | |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1568 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.086 |