| National Provider Identifier [NPI]: | 1346489630 |
| Last Name Of The Provider | LARGE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8040 CLEARVISTA PKWY |
| Street Address 2 Of The Provider | SUITE 370 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462565630 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 105 |
| Number Of Services | 4940 |
| Number Of Medicare Beneficiaries | 355 |
| Total Submitted Charge Amount | 939287 |
| Total Medicare Allowed Amount | 282525 |
| Total Medicare Payment Amount | 219827.25 |
| Total Medicare Standardized Payment Amount | 229762.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 3407 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 188791 |
| Total Drug Medicare AllowedAmount | 110863.94 |
| Total Drug Medicare PaymentAmount | 86856.42 |
| Total Drug Medicare Standardized Payment Amount | 86856.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 98 |
| Number Of Medical Services | 1533 |
| Number Of Medicare Beneficiaries With Medical Services | 355 |
| Total Medical Submitted Charge Amount | 750496 |
| Total Medical Medicare Allowed Amount | 171661.06 |
| Total Medical Medicare Payment Amount | 132970.83 |
| Total Medical Medicare Standardized Payment Amount | 142906.36 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 42 |
| Number Of Beneficiaries Age 65 to 74 | 145 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 67 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 222 |
| Number Of Non Hispanic White Beneficiaries | 285 |
| 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 | 286 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7798 |