| National Provider Identifier [NPI]: | 1689661621 |
| Last Name Of The Provider | ENOCHS |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D., PH.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | BRYN MAWR HOSPITAL, DEPARTMENT OF RADIOLOGY |
| Street Address 2 Of The Provider | 130 SOUTH BRYN MAWR AVE. |
| City Of The Provider | BRYN MAWR |
| Zip Code Of The Provider | 19010 |
| 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 | 128 |
| Number Of Services | 5032 |
| Number Of Medicare Beneficiaries | 2589 |
| Total Submitted Charge Amount | 1608955.1 |
| Total Medicare Allowed Amount | 324345.32 |
| Total Medicare Payment Amount | 249331.81 |
| Total Medicare Standardized Payment Amount | 242092.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1227 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 5646.1 |
| Total Drug Medicare AllowedAmount | 566.64 |
| Total Drug Medicare PaymentAmount | 444.2 |
| Total Drug Medicare Standardized Payment Amount | 444.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 3805 |
| Number Of Medicare Beneficiaries With Medical Services | 2589 |
| Total Medical Submitted Charge Amount | 1603309 |
| Total Medical Medicare Allowed Amount | 323778.68 |
| Total Medical Medicare Payment Amount | 248887.61 |
| Total Medical Medicare Standardized Payment Amount | 241647.81 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 854 |
| Number Of Beneficiaries Age 75 to 84 | 810 |
| Number Of Beneficiaries Age Greater 84 | 716 |
| Number Of Female Beneficiaries | 1509 |
| Number Of Male Beneficiaries | 1080 |
| Number Of Non Hispanic White Beneficiaries | 2310 |
| Number Of Black or African American Beneficiaries | 178 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 262 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 1.6678 |