| National Provider Identifier [NPI]: | 1336402197 |
| Last Name Of The Provider | PELLEGRIN |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | NP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2010 HEALTH CAMPUS DR |
| Street Address 2 Of The Provider | EMERGENCY DEPARTMENT |
| City Of The Provider | HARRISONBURG |
| Zip Code Of The Provider | 22801 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 223 |
| Number Of Medicare Beneficiaries | 126 |
| Total Submitted Charge Amount | 30643 |
| Total Medicare Allowed Amount | 12221.13 |
| Total Medicare Payment Amount | 8845.9 |
| Total Medicare Standardized Payment Amount | 11081.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 850 |
| Total Drug Medicare AllowedAmount | 134.13 |
| Total Drug Medicare PaymentAmount | 116.91 |
| Total Drug Medicare Standardized Payment Amount | 116.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 196 |
| Number Of Medicare Beneficiaries With Medical Services | 126 |
| Total Medical Submitted Charge Amount | 29793 |
| Total Medical Medicare Allowed Amount | 12087 |
| Total Medical Medicare Payment Amount | 8728.99 |
| Total Medical Medicare Standardized Payment Amount | 10964.44 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 85 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 92 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9015 |