National Provider Identifier [NPI]: |
1255595054 |
Last Name Of The Provider |
MENDOZA-MANCINI |
First Name Of The Provider |
PAULINA |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
6TH AVENUE & SPRUCE STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
WEST READING |
Zip Code Of The Provider |
196113335 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
19 |
Number Of Services |
519 |
Number Of Medicare Beneficiaries |
467 |
Total Submitted Charge Amount |
320900 |
Total Medicare Allowed Amount |
77334.68 |
Total Medicare Payment Amount |
59915.56 |
Total Medicare Standardized Payment Amount |
59849.95 |
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 |
519 |
Number Of Medicare Beneficiaries With Medical Services |
467 |
Total Medical Submitted Charge Amount |
320900 |
Total Medical Medicare Allowed Amount |
77334.68 |
Total Medical Medicare Payment Amount |
59915.56 |
Total Medical Medicare Standardized Payment Amount |
59849.95 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
125 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
132 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
258 |
Number Of Male Beneficiaries |
209 |
Number Of Non Hispanic White Beneficiaries |
202 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
242 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
171 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
296 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
17 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.3395 |