| National Provider Identifier [NPI]: | 1558393611 |
| Last Name Of The Provider | ALTADONNA |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2106 HARRISBURG PIKE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | LANCASTER |
| Zip Code Of The Provider | 176012644 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 9075 |
| Number Of Medicare Beneficiaries | 1211 |
| Total Submitted Charge Amount | 878149.3 |
| Total Medicare Allowed Amount | 299862.39 |
| Total Medicare Payment Amount | 219998.53 |
| Total Medicare Standardized Payment Amount | 228641.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 4504 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 82588 |
| Total Drug Medicare AllowedAmount | 31002.98 |
| Total Drug Medicare PaymentAmount | 23786.3 |
| Total Drug Medicare Standardized Payment Amount | 23786.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 108 |
| Number Of Medical Services | 4571 |
| Number Of Medicare Beneficiaries With Medical Services | 1211 |
| Total Medical Submitted Charge Amount | 795561.3 |
| Total Medical Medicare Allowed Amount | 268859.41 |
| Total Medical Medicare Payment Amount | 196212.23 |
| Total Medical Medicare Standardized Payment Amount | 204855.5 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 367 |
| Number Of Beneficiaries Age 75 to 84 | 501 |
| Number Of Beneficiaries Age Greater 84 | 270 |
| Number Of Female Beneficiaries | 232 |
| Number Of Male Beneficiaries | 979 |
| Number Of Non Hispanic White Beneficiaries | 1149 |
| Number Of Black or African American Beneficiaries | 15 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 88 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 28 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4019 |