| National Provider Identifier [NPI]: | 1164582052 |
| Last Name Of The Provider | NEITHARDT |
| First Name Of The Provider | GREGG |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 915 OLD FERN HILL RD |
| Street Address 2 Of The Provider | BLDG A, STE 5 |
| City Of The Provider | WEST CHESTER |
| Zip Code Of The Provider | 193804269 |
| 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 | 58 |
| Number Of Services | 3548 |
| Number Of Medicare Beneficiaries | 1277 |
| Total Submitted Charge Amount | 795198.16 |
| Total Medicare Allowed Amount | 298082.21 |
| Total Medicare Payment Amount | 227051.88 |
| Total Medicare Standardized Payment Amount | 215432.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 132 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 6789.27 |
| Total Drug Medicare AllowedAmount | 6789.27 |
| Total Drug Medicare PaymentAmount | 5322.86 |
| Total Drug Medicare Standardized Payment Amount | 5322.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 3416 |
| Number Of Medicare Beneficiaries With Medical Services | 1277 |
| Total Medical Submitted Charge Amount | 788408.89 |
| Total Medical Medicare Allowed Amount | 291292.94 |
| Total Medical Medicare Payment Amount | 221729.02 |
| Total Medical Medicare Standardized Payment Amount | 210109.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 564 |
| Number Of Beneficiaries Age 75 to 84 | 359 |
| Number Of Beneficiaries Age Greater 84 | 262 |
| Number Of Female Beneficiaries | 664 |
| Number Of Male Beneficiaries | 613 |
| Number Of Non Hispanic White Beneficiaries | 1125 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 109 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.5826 |