| National Provider Identifier [NPI]: | 1285635284 |
| Last Name Of The Provider | FODERARO |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 711 LAWN AVE |
| Street Address 2 Of The Provider | BLDG 1 |
| City Of The Provider | SELLERSVILLE |
| Zip Code Of The Provider | 189601575 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 3467.5 |
| Number Of Medicare Beneficiaries | 2081 |
| Total Submitted Charge Amount | 447206 |
| Total Medicare Allowed Amount | 131534.66 |
| Total Medicare Payment Amount | 103270.22 |
| Total Medicare Standardized Payment Amount | 99200.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 117.5 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1175 |
| Total Drug Medicare AllowedAmount | 231.8 |
| Total Drug Medicare PaymentAmount | 181.68 |
| Total Drug Medicare Standardized Payment Amount | 181.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 151 |
| Number Of Medical Services | 3350 |
| Number Of Medicare Beneficiaries With Medical Services | 2081 |
| Total Medical Submitted Charge Amount | 446031 |
| Total Medical Medicare Allowed Amount | 131302.86 |
| Total Medical Medicare Payment Amount | 103088.54 |
| Total Medical Medicare Standardized Payment Amount | 99018.39 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 242 |
| Number Of Beneficiaries Age 65 to 74 | 822 |
| Number Of Beneficiaries Age 75 to 84 | 616 |
| Number Of Beneficiaries Age Greater 84 | 401 |
| Number Of Female Beneficiaries | 1243 |
| Number Of Male Beneficiaries | 838 |
| Number Of Non Hispanic White Beneficiaries | 2007 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1794 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 287 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.4786 |