| National Provider Identifier [NPI]: | 1902119654 |
| Last Name Of The Provider | VILBERT |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD,CM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 130 S BRYN MAWR AVE |
| Street Address 2 Of The Provider | BRYN MAWR HOSPITAL - DEPT OF RADIOLOGY |
| City Of The Provider | BRYN MAWR |
| Zip Code Of The Provider | 190103121 |
| 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 | 179 |
| Number Of Services | 4223 |
| Number Of Medicare Beneficiaries | 2359 |
| Total Submitted Charge Amount | 458032 |
| Total Medicare Allowed Amount | 131179.22 |
| Total Medicare Payment Amount | 100490.31 |
| Total Medicare Standardized Payment Amount | 104405.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 179 |
| Number Of Medical Services | 4223 |
| Number Of Medicare Beneficiaries With Medical Services | 2359 |
| Total Medical Submitted Charge Amount | 458032 |
| Total Medical Medicare Allowed Amount | 131179.22 |
| Total Medical Medicare Payment Amount | 100490.31 |
| Total Medical Medicare Standardized Payment Amount | 104405.56 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 481 |
| Number Of Beneficiaries Age 65 to 74 | 770 |
| Number Of Beneficiaries Age 75 to 84 | 680 |
| Number Of Beneficiaries Age Greater 84 | 428 |
| Number Of Female Beneficiaries | 1423 |
| Number Of Male Beneficiaries | 936 |
| Number Of Non Hispanic White Beneficiaries | 2295 |
| Number Of Black or African American Beneficiaries | 17 |
| 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 | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1711 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 648 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6414 |