| National Provider Identifier [NPI]: | 1154370914 |
| Last Name Of The Provider | PELINI |
| First Name Of The Provider | SUSAN |
| 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 | 6410 FANNIN ST |
| Street Address 2 Of The Provider | 600 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770303000 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 686 |
| Number Of Medicare Beneficiaries | 240 |
| Total Submitted Charge Amount | 118828 |
| Total Medicare Allowed Amount | 54374.28 |
| Total Medicare Payment Amount | 39978.25 |
| Total Medicare Standardized Payment Amount | 40324.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 26 |
| Number Of Medicare Beneficiaries With Drug Services | 24 |
| Total Drug Submitted ChargeAmount | 1724 |
| Total Drug Medicare AllowedAmount | 755.57 |
| Total Drug Medicare PaymentAmount | 670.14 |
| Total Drug Medicare Standardized Payment Amount | 670.14 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 660 |
| Number Of Medicare Beneficiaries With Medical Services | 240 |
| Total Medical Submitted Charge Amount | 117104 |
| Total Medical Medicare Allowed Amount | 53618.71 |
| Total Medical Medicare Payment Amount | 39308.11 |
| Total Medical Medicare Standardized Payment Amount | 39654.77 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 107 |
| Number Of Beneficiaries Age 65 to 74 | 75 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 143 |
| Number Of Male Beneficiaries | 97 |
| Number Of Non Hispanic White Beneficiaries | 118 |
| Number Of Black or African American Beneficiaries | 94 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 168 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 72 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 22 |
| Average HCC Risk Score Of Beneficiaries | 1.9453 |