| National Provider Identifier [NPI]: | 1851445696 |
| Last Name Of The Provider | DUSCH |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3 S PENNELL RD |
| Street Address 2 Of The Provider | INSIDE CVS PHARMACY |
| City Of The Provider | MEDIA |
| Zip Code Of The Provider | 190635258 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 18 |
| Number Of Services | 360 |
| Number Of Medicare Beneficiaries | 209 |
| Total Submitted Charge Amount | 15524.78 |
| Total Medicare Allowed Amount | 14601.07 |
| Total Medicare Payment Amount | 11357.38 |
| Total Medicare Standardized Payment Amount | 12844.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 122 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 3551.78 |
| Total Drug Medicare AllowedAmount | 3551.78 |
| Total Drug Medicare PaymentAmount | 3480.72 |
| Total Drug Medicare Standardized Payment Amount | 3480.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 11 |
| Number Of Medical Services | 238 |
| Number Of Medicare Beneficiaries With Medical Services | 209 |
| Total Medical Submitted Charge Amount | 11973 |
| Total Medical Medicare Allowed Amount | 11049.29 |
| Total Medical Medicare Payment Amount | 7876.66 |
| Total Medical Medicare Standardized Payment Amount | 9363.4 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 46 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 67 |
| Number Of Non Hispanic White Beneficiaries | 168 |
| Number Of Black or African American Beneficiaries | 29 |
| 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 | 193 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8317 |