Medicare billing address
CMS Medicare provider billing file
3401 N Broad StPhiladelphia, PA 19140
CMS public data · NPI 1013905157
Dr. Gerard Criner: Medicare prescribing and billing data
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
Gerard Criner, MD
Specialty
Credential
MD
NPI
1013905157
Primary source state
PA
Data retrieval date
July 26, 2026
What related Medicare data is on this site?
Pennsylvania doctorsState Doctor hubPulmonary DiseaseState-specialty hubPhiladelphia, PAPrimary city link if this route exists
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
How should you read this Doctor page?
This page shows Medicare billing and Part D prescribing data for Gerard Criner, MD from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Do your doctors and prescriptions fit before you enroll?
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
What Medicare source indicators are listed for this NPI?
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
Which practice locations appear in CMS files?
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
Philadelphia, PA 19140
TEMPLE FACULTY PRACTICE PLAN INC
CMS Doctors & Clinicians file
3401 N Broad StPhiladelphia, PA 19140
What does the Medicare billing file show?
In the 2024 CMS provider billing file, this NPI had 684 Medicare beneficiaries and 11,546 total services. The average beneficiary age was 72, and the average HCC risk score was 2.4.
Total Medicare allowed amount
$643,480.55
Total Medicare payment amount
$504,631.28
Medicare beneficiaries
684
Total services
11,546
Which patient-panel condition fields does CMS report?
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
COPD
75%
CMS beneficiary-panel share
Hyperlipidemia
75%
CMS beneficiary-panel share
Hypertension
75%
CMS beneficiary-panel share
Ischemic heart disease
58%
CMS beneficiary-panel share
Chronic kidney disease
38%
CMS beneficiary-panel share
Anxiety
37%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
Which Medicare services appear most often?
| CMS service description | Services | Avg allowed |
|---|---|---|
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 573 | $145.09 |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 311 | $184.88 |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 187 | $79.18 |
| Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 155 | $49.41 |
| Injection of drug or substance under skin or into muscle | 146 | $14.74 |
| Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 133 | $35.54 |
| Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 120 | $63.11 |
| Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month | 105 | $69.07 |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 94 | $131.10 |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 92 | $97.48 |
Where these Part D numbers come from, and what they cannot tell you
CMS data reports historical prescription drug events attributed to NPI 1013905157. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.
Which drugs did Gerard Criner, MD prescribe most often under Medicare Part D?
| Rank | Drug | Generic name | Total claims | 30-day fills | Total drug cost |
|---|---|---|---|---|---|
| 1 | Ofev | Nintedanib Esylate | 176 | 185 | $1,832,392.09 |
| 2 | Trelegy Ellipta | Fluticasone/Umeclidin/Vilanter | 154 | 214 | $134,100.69 |
| 3 | Prednisone | Prednisone | 105 | 190.3 | $655.74 |
| 4 | Azithromycin | Azithromycin | 94 | 105.6 | $640.34 |
| 5 | Albuterol Sulfate Hfa | Albuterol Sulfate | 86 | 119.7 | $3,110.32 |
| 6 | Sulfamethoxazole-Trimethoprim | Sulfamethoxazole/Trimethoprim | 81 | 114.2 | $361.99 |
| 7 | Anoro Ellipta | Umeclidinium Brm/Vilanterol Tr | 53 | 71 | $32,119.02 |
| 8 | Breztri Aerosphere | Budesonide/Glycopyr/Formoterol | 52 | 68 | $42,738.41 |
| 9 | Atovaquone | Atovaquone | 48 | 48.4 | $28,458.48 |
| 10 | Pantoprazole Sodium | Pantoprazole Sodium | 40 | 70 | $177.55 |
CMS Part D records are historical aggregate claims data. They do not include current formulary status, pharmacy price, prior-authorization rules, network-directory status, or clinical-outcome data.
What background fields does CMS report?
Medical school
Temple University School Of Medicine
Graduation year
1979
Group/practice field
Temple Faculty Practice Plan Inc
Telehealth reported
Yes
Secondary specialty fields reported by CMS: Critical Care (Intensivists).
What can this data not tell us?
- Billing data and prescribing data come from different CMS files. Neither one measures clinical outcomes, and neither one tells you whether this doctor is in a specific plan's network.
- Part D records do not report current medication use, plan coverage, price, pharmacy availability, or plan-directory status.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
- CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
- CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
- Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.
What should you verify separately?
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
Which CMS sources support this page?
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.
- Medicare Physician & Other Practitioners - by Provider · 1 records for this NPI · retrieved July 26, 2026
- Medicare Physician & Other Practitioners - by Provider and Service · 30 records for this NPI · retrieved July 26, 2026
- Doctors and Clinicians National Downloadable File · 1 records for this NPI · retrieved July 26, 2026
- Opt-Out Affidavits · 0 records for this NPI · retrieved July 26, 2026
- Medicare Part D Prescribers - by Provider and Drug · 36 records for this NPI · retrieved July 26, 2026
What caveats apply to this page?
- CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
- Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.