| National Provider Identifier [NPI]: | 1427034875 |
| Last Name Of The Provider | TRICE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4940 EASTERN AVE |
| Street Address 2 Of The Provider | A BLG, 6TH FLOOR |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212242735 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 171 |
| Number Of Medicare Beneficiaries | 34 |
| Total Submitted Charge Amount | 62388 |
| Total Medicare Allowed Amount | 14478.53 |
| Total Medicare Payment Amount | 9486.86 |
| Total Medicare Standardized Payment Amount | 9806.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 54 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 6026 |
| Total Drug Medicare AllowedAmount | 3141.05 |
| Total Drug Medicare PaymentAmount | 2218.4 |
| Total Drug Medicare Standardized Payment Amount | 2218.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 117 |
| Number Of Medicare Beneficiaries With Medical Services | 34 |
| Total Medical Submitted Charge Amount | 56362 |
| Total Medical Medicare Allowed Amount | 11337.48 |
| Total Medical Medicare Payment Amount | 7268.46 |
| Total Medical Medicare Standardized Payment Amount | 7587.88 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 16 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 22 |
| Number Of Male Beneficiaries | 12 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 0 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2193 |