| National Provider Identifier [NPI]: | 1770592792 |
| Last Name Of The Provider | PEMBERTON |
| First Name Of The Provider | CLIFFORD |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 LANCASTER AVE |
| Street Address 2 Of The Provider | MAIN LINE ONCOLOGY HEMOTOLOGY ASSOCIATES |
| City Of The Provider | WYNNEWOOD |
| Zip Code Of The Provider | 19096 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 77804 |
| Number Of Medicare Beneficiaries | 383 |
| Total Submitted Charge Amount | 1958063 |
| Total Medicare Allowed Amount | 841095.46 |
| Total Medicare Payment Amount | 653920.68 |
| Total Medicare Standardized Payment Amount | 634219.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 39 |
| Number Of Drug Services | 74699 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 1467466 |
| Total Drug Medicare AllowedAmount | 647908.85 |
| Total Drug Medicare PaymentAmount | 507070.89 |
| Total Drug Medicare Standardized Payment Amount | 507070.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 31 |
| Number Of Medical Services | 3105 |
| Number Of Medicare Beneficiaries With Medical Services | 383 |
| Total Medical Submitted Charge Amount | 490597 |
| Total Medical Medicare Allowed Amount | 193186.61 |
| Total Medical Medicare Payment Amount | 146849.79 |
| Total Medical Medicare Standardized Payment Amount | 127148.33 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 232 |
| Number Of Male Beneficiaries | 151 |
| Number Of Non Hispanic White Beneficiaries | 294 |
| Number Of Black or African American Beneficiaries | |
| 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 | 349 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.2898 |