| National Provider Identifier [NPI]: | 1841275203 |
| Last Name Of The Provider | BEATTY |
| First Name Of The Provider | TRICIA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 925 CHESTNUT ST FL 5 |
| Street Address 2 Of The Provider | ROTHMAN INSTITUTE |
| City Of The Provider | PHILADELPHIA |
| Zip Code Of The Provider | 191074206 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 3944 |
| Number Of Medicare Beneficiaries | 590 |
| Total Submitted Charge Amount | 735808 |
| Total Medicare Allowed Amount | 298325.78 |
| Total Medicare Payment Amount | 226707.45 |
| Total Medicare Standardized Payment Amount | 212800.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1355 |
| Number Of Medicare Beneficiaries With Drug Services | 401 |
| Total Drug Submitted ChargeAmount | 198443 |
| Total Drug Medicare AllowedAmount | 96843.19 |
| Total Drug Medicare PaymentAmount | 75594.96 |
| Total Drug Medicare Standardized Payment Amount | 75594.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 2589 |
| Number Of Medicare Beneficiaries With Medical Services | 590 |
| Total Medical Submitted Charge Amount | 537365 |
| Total Medical Medicare Allowed Amount | 201482.59 |
| Total Medical Medicare Payment Amount | 151112.49 |
| Total Medical Medicare Standardized Payment Amount | 137205.82 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 179 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 166 |
| Number Of Non Hispanic White Beneficiaries | 491 |
| Number Of Black or African American Beneficiaries | 78 |
| 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 | 562 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 28 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0304 |