| National Provider Identifier [NPI]: | 1609846674 |
| Last Name Of The Provider | PANCHOLY |
| First Name Of The Provider | SAMIR |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 231 NORTHERN BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH ABINGTON TOWNSHIP |
| Zip Code Of The Provider | 184119189 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 6677 |
| Number Of Medicare Beneficiaries | 1532 |
| Total Submitted Charge Amount | 1589905 |
| Total Medicare Allowed Amount | 772068.1 |
| Total Medicare Payment Amount | 577620.06 |
| Total Medicare Standardized Payment Amount | 601930.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 697 |
| Number Of Medicare Beneficiaries With Drug Services | 178 |
| Total Drug Submitted ChargeAmount | 45305 |
| Total Drug Medicare AllowedAmount | 36903.65 |
| Total Drug Medicare PaymentAmount | 28681.35 |
| Total Drug Medicare Standardized Payment Amount | 28681.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 5980 |
| Number Of Medicare Beneficiaries With Medical Services | 1532 |
| Total Medical Submitted Charge Amount | 1544600 |
| Total Medical Medicare Allowed Amount | 735164.45 |
| Total Medical Medicare Payment Amount | 548938.71 |
| Total Medical Medicare Standardized Payment Amount | 573248.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 163 |
| Number Of Beneficiaries Age 65 to 74 | 583 |
| Number Of Beneficiaries Age 75 to 84 | 491 |
| Number Of Beneficiaries Age Greater 84 | 295 |
| Number Of Female Beneficiaries | 776 |
| Number Of Male Beneficiaries | 756 |
| Number Of Non Hispanic White Beneficiaries | 1481 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 259 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5029 |