| National Provider Identifier [NPI]: | 1174858138 |
| Last Name Of The Provider | MANNELLI |
| First Name Of The Provider | LORENZO |
| Middle Initial Of The Provider | |
| 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 | 1959 NE PACIFIC STREET |
| Street Address 2 Of The Provider | BOX 357115 |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981957115 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 532 |
| Number Of Medicare Beneficiaries | 344 |
| Total Submitted Charge Amount | 195830 |
| Total Medicare Allowed Amount | 39142.33 |
| Total Medicare Payment Amount | 30687.42 |
| Total Medicare Standardized Payment Amount | 29673.57 |
| 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 | 33 |
| Number Of Medical Services | 532 |
| Number Of Medicare Beneficiaries With Medical Services | 344 |
| Total Medical Submitted Charge Amount | 195830 |
| Total Medical Medicare Allowed Amount | 39142.33 |
| Total Medical Medicare Payment Amount | 30687.42 |
| Total Medical Medicare Standardized Payment Amount | 29673.57 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 112 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 168 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 274 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 298 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 47 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.933 |