| National Provider Identifier [NPI]: | 1902059652 |
| Last Name Of The Provider | PONDUCHI |
| First Name Of The Provider | MIRELA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21001 N TATUM BLVD |
| Street Address 2 Of The Provider | SUITE 1630-463 |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850504206 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 625 |
| Number Of Medicare Beneficiaries | 280 |
| Total Submitted Charge Amount | 135430 |
| Total Medicare Allowed Amount | 67623.71 |
| Total Medicare Payment Amount | 51397.02 |
| Total Medicare Standardized Payment Amount | 52585.13 |
| 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 | 19 |
| Number Of Medical Services | 625 |
| Number Of Medicare Beneficiaries With Medical Services | 280 |
| Total Medical Submitted Charge Amount | 135430 |
| Total Medical Medicare Allowed Amount | 67623.71 |
| Total Medical Medicare Payment Amount | 51397.02 |
| Total Medical Medicare Standardized Payment Amount | 52585.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 103 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 47 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 140 |
| Number Of Non Hispanic White Beneficiaries | 231 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 211 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 42 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.5783 |