National Provider Identifier [NPI]: |
1184692352 |
Last Name Of The Provider |
MANDELL |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
M.D, |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2298 NW 60TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BOCA RATON |
Zip Code Of The Provider |
334963506 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
42 |
Number Of Services |
359 |
Number Of Medicare Beneficiaries |
204 |
Total Submitted Charge Amount |
44544 |
Total Medicare Allowed Amount |
7777.94 |
Total Medicare Payment Amount |
5468.42 |
Total Medicare Standardized Payment Amount |
5041.97 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
359 |
Number Of Medicare Beneficiaries With Medical Services |
204 |
Total Medical Submitted Charge Amount |
44544 |
Total Medical Medicare Allowed Amount |
7777.94 |
Total Medical Medicare Payment Amount |
5468.42 |
Total Medical Medicare Standardized Payment Amount |
5041.97 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
71 |
Number Of Beneficiaries Age 65 to 74 |
67 |
Number Of Beneficiaries Age 75 to 84 |
42 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
118 |
Number Of Male Beneficiaries |
86 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
119 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
51 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
33 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
171 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
46 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
59 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
56 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
71 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
75 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
26 |
Percent Of With Stroke |
22 |
Average HCC Risk Score Of Beneficiaries |
3.5597 |