| National Provider Identifier [NPI]: | 1104814243 |
| Last Name Of The Provider | KELSEN |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3401 N BROAD ST |
| Street Address 2 Of The Provider | 7TH FLR PARKINSON PAVILION |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191405103 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 2638 |
| Number Of Medicare Beneficiaries | 125 |
| Total Submitted Charge Amount | 143899 |
| Total Medicare Allowed Amount | 86617.12 |
| Total Medicare Payment Amount | 66870.67 |
| Total Medicare Standardized Payment Amount | 62893.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2198 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 88724 |
| Total Drug Medicare AllowedAmount | 58779.54 |
| Total Drug Medicare PaymentAmount | 46110.3 |
| Total Drug Medicare Standardized Payment Amount | 46110.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 440 |
| Number Of Medicare Beneficiaries With Medical Services | 125 |
| Total Medical Submitted Charge Amount | 55175 |
| Total Medical Medicare Allowed Amount | 27837.58 |
| Total Medical Medicare Payment Amount | 20760.37 |
| Total Medical Medicare Standardized Payment Amount | 16783.05 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 56 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 59 |
| Number Of Black or African American Beneficiaries | 44 |
| 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 | 66 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 43 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 61 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.3141 |