| National Provider Identifier [NPI]: | 1154325082 |
| Last Name Of The Provider | AVELLONE |
| First Name Of The Provider | AMANDA |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1390 HIGHWAY 61 |
| Street Address 2 Of The Provider | STE 2300 |
| City Of The Provider | FESTUS |
| Zip Code Of The Provider | 630284121 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 2715 |
| Number Of Medicare Beneficiaries | 968 |
| Total Submitted Charge Amount | 567252.5 |
| Total Medicare Allowed Amount | 251548.5 |
| Total Medicare Payment Amount | 191437.26 |
| Total Medicare Standardized Payment Amount | 188082.25 |
| 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 | 40 |
| Number Of Medical Services | 2715 |
| Number Of Medicare Beneficiaries With Medical Services | 968 |
| Total Medical Submitted Charge Amount | 567252.5 |
| Total Medical Medicare Allowed Amount | 251548.5 |
| Total Medical Medicare Payment Amount | 191437.26 |
| Total Medical Medicare Standardized Payment Amount | 188082.25 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 276 |
| Number Of Beneficiaries Age 65 to 74 | 356 |
| Number Of Beneficiaries Age 75 to 84 | 261 |
| Number Of Beneficiaries Age Greater 84 | 75 |
| Number Of Female Beneficiaries | 485 |
| Number Of Male Beneficiaries | 483 |
| Number Of Non Hispanic White Beneficiaries | 943 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 652 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 316 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 59 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9211 |