| National Provider Identifier [NPI]: | 1841487204 |
| Last Name Of The Provider | BENSTOCK |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 S 11TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191074824 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 131 |
| Number Of Services | 6850 |
| Number Of Medicare Beneficiaries | 3557 |
| Total Submitted Charge Amount | 1728719.27 |
| Total Medicare Allowed Amount | 353548.92 |
| Total Medicare Payment Amount | 273160.66 |
| Total Medicare Standardized Payment Amount | 263984.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1311 |
| Number Of Medicare Beneficiaries With Drug Services | 137 |
| Total Drug Submitted ChargeAmount | 5848.27 |
| Total Drug Medicare AllowedAmount | 588.71 |
| Total Drug Medicare PaymentAmount | 461.5 |
| Total Drug Medicare Standardized Payment Amount | 461.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 129 |
| Number Of Medical Services | 5539 |
| Number Of Medicare Beneficiaries With Medical Services | 3557 |
| Total Medical Submitted Charge Amount | 1722871 |
| Total Medical Medicare Allowed Amount | 352960.21 |
| Total Medical Medicare Payment Amount | 272699.16 |
| Total Medical Medicare Standardized Payment Amount | 263522.88 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 296 |
| Number Of Beneficiaries Age 65 to 74 | 1198 |
| Number Of Beneficiaries Age 75 to 84 | 1109 |
| Number Of Beneficiaries Age Greater 84 | 954 |
| Number Of Female Beneficiaries | 2099 |
| Number Of Male Beneficiaries | 1458 |
| Number Of Non Hispanic White Beneficiaries | 3019 |
| Number Of Black or African American Beneficiaries | 402 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 66 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3111 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 446 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 1.7789 |