| National Provider Identifier [NPI]: | 1346240488 |
| Last Name Of The Provider | MANTELL |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1569 MATTHEW DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | FT MYERS |
| Zip Code Of The Provider | 339071734 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 6580 |
| Number Of Medicare Beneficiaries | 620 |
| Total Submitted Charge Amount | 617039 |
| Total Medicare Allowed Amount | 283916.54 |
| Total Medicare Payment Amount | 225223.68 |
| Total Medicare Standardized Payment Amount | 218926.65 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 4221 |
| Number Of Medicare Beneficiaries With Drug Services | 283 |
| Total Drug Submitted ChargeAmount | 162275 |
| Total Drug Medicare AllowedAmount | 78140.94 |
| Total Drug Medicare PaymentAmount | 65147.59 |
| Total Drug Medicare Standardized Payment Amount | 65147.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 2359 |
| Number Of Medicare Beneficiaries With Medical Services | 619 |
| Total Medical Submitted Charge Amount | 454764 |
| Total Medical Medicare Allowed Amount | 205775.6 |
| Total Medical Medicare Payment Amount | 160076.09 |
| Total Medical Medicare Standardized Payment Amount | 153779.06 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 184 |
| Number Of Beneficiaries Age 75 to 84 | 210 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 357 |
| Number Of Male Beneficiaries | 263 |
| Number Of Non Hispanic White Beneficiaries | 590 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 603 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.0339 |