| National Provider Identifier [NPI]: | 1730169590 |
| Last Name Of The Provider | MAN |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8926 WOODYARD RD |
| Street Address 2 Of The Provider | SUITE 301 |
| City Of The Provider | CLINTON |
| Zip Code Of The Provider | 207354220 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 13750.5 |
| Number Of Medicare Beneficiaries | 1567 |
| Total Submitted Charge Amount | 1610171.34 |
| Total Medicare Allowed Amount | 378088.81 |
| Total Medicare Payment Amount | 282457.61 |
| Total Medicare Standardized Payment Amount | 285620.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11415.5 |
| Number Of Medicare Beneficiaries With Drug Services | 257 |
| Total Drug Submitted ChargeAmount | 9349.15 |
| Total Drug Medicare AllowedAmount | 6472.19 |
| Total Drug Medicare PaymentAmount | 4886.79 |
| Total Drug Medicare Standardized Payment Amount | 4886.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 163 |
| Number Of Medical Services | 2335 |
| Number Of Medicare Beneficiaries With Medical Services | 1567 |
| Total Medical Submitted Charge Amount | 1600822.19 |
| Total Medical Medicare Allowed Amount | 371616.62 |
| Total Medical Medicare Payment Amount | 277570.82 |
| Total Medical Medicare Standardized Payment Amount | 280733.86 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 172 |
| Number Of Beneficiaries Age 65 to 74 | 832 |
| Number Of Beneficiaries Age 75 to 84 | 432 |
| Number Of Beneficiaries Age Greater 84 | 131 |
| Number Of Female Beneficiaries | 1084 |
| Number Of Male Beneficiaries | 483 |
| Number Of Non Hispanic White Beneficiaries | 1127 |
| Number Of Black or African American Beneficiaries | 298 |
| Number Of AsianPacific Islander Beneficiaries | 71 |
| Number Of Hispanic Beneficiaries | 42 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1394 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 173 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9969 |