| National Provider Identifier [NPI]: | 1386790053 |
| Last Name Of The Provider | KLIGERMAN |
| First Name Of The Provider | SETH |
| 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 | 22 S GREENE ST |
| Street Address 2 Of The Provider | ROOM N2W78 |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212011544 |
| 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 | 15 |
| Number Of Services | 2755 |
| Number Of Medicare Beneficiaries | 1231 |
| Total Submitted Charge Amount | 233231.82 |
| Total Medicare Allowed Amount | 58954.51 |
| Total Medicare Payment Amount | 44519.74 |
| Total Medicare Standardized Payment Amount | 43611.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 907 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 235.82 |
| Total Drug Medicare AllowedAmount | 153.88 |
| Total Drug Medicare PaymentAmount | 111.24 |
| Total Drug Medicare Standardized Payment Amount | 111.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 14 |
| Number Of Medical Services | 1848 |
| Number Of Medicare Beneficiaries With Medical Services | 1231 |
| Total Medical Submitted Charge Amount | 232996 |
| Total Medical Medicare Allowed Amount | 58800.63 |
| Total Medical Medicare Payment Amount | 44408.5 |
| Total Medical Medicare Standardized Payment Amount | 43500.5 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 319 |
| Number Of Beneficiaries Age 65 to 74 | 511 |
| Number Of Beneficiaries Age 75 to 84 | 294 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 589 |
| Number Of Male Beneficiaries | 642 |
| Number Of Non Hispanic White Beneficiaries | 714 |
| Number Of Black or African American Beneficiaries | 450 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 875 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 356 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 57 |
| Percent Of With Chronic Kidney Disease | 60 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.7375 |