National Provider Identifier [NPI]: |
1043219629 |
Last Name Of The Provider |
MENDEL |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3401 COMMISSION CT |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
WOODBRIDGE |
Zip Code Of The Provider |
221921771 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
1272.5 |
Number Of Medicare Beneficiaries |
312 |
Total Submitted Charge Amount |
126006.5 |
Total Medicare Allowed Amount |
85652.5 |
Total Medicare Payment Amount |
59431.69 |
Total Medicare Standardized Payment Amount |
62288.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
74.5 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
4637.5 |
Total Drug Medicare AllowedAmount |
2821.6 |
Total Drug Medicare PaymentAmount |
2762.29 |
Total Drug Medicare Standardized Payment Amount |
2762.29 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
1198 |
Number Of Medicare Beneficiaries With Medical Services |
312 |
Total Medical Submitted Charge Amount |
121369 |
Total Medical Medicare Allowed Amount |
82830.9 |
Total Medical Medicare Payment Amount |
56669.4 |
Total Medical Medicare Standardized Payment Amount |
59526.69 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
245 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
163 |
Number Of Non Hispanic White Beneficiaries |
282 |
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 |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
6 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
18 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
49 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7318 |