| National Provider Identifier [NPI]: | 1376611194 |
| Last Name Of The Provider | STADLEN |
| First Name Of The Provider | SALLIE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3475 W CHESTER PIKE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | NEWTOWN SQUARE |
| Zip Code Of The Provider | 190734294 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 520 |
| Number Of Medicare Beneficiaries | 219 |
| Total Submitted Charge Amount | 56538.53 |
| Total Medicare Allowed Amount | 49435.28 |
| Total Medicare Payment Amount | 32781.77 |
| Total Medicare Standardized Payment Amount | 30984.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 25 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1330 |
| Total Drug Medicare AllowedAmount | 939.6 |
| Total Drug Medicare PaymentAmount | 905.54 |
| Total Drug Medicare Standardized Payment Amount | 905.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 17 |
| Number Of Medical Services | 495 |
| Number Of Medicare Beneficiaries With Medical Services | 219 |
| Total Medical Submitted Charge Amount | 55208.53 |
| Total Medical Medicare Allowed Amount | 48495.68 |
| Total Medical Medicare Payment Amount | 31876.23 |
| Total Medical Medicare Standardized Payment Amount | 30078.52 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 67 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 201 |
| Number Of Male Beneficiaries | 18 |
| Number Of Non Hispanic White Beneficiaries | 200 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 7 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7866 |