| National Provider Identifier [NPI]: | 1326017682 |
| Last Name Of The Provider | MAULICK |
| First Name Of The Provider | NANCY |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1255 S CEDAR CREST BLVD |
| Street Address 2 Of The Provider | SUITE 2200 |
| City Of The Provider | ALLENTOWN |
| Zip Code Of The Provider | 181036256 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 185 |
| Number Of Medicare Beneficiaries | 90 |
| Total Submitted Charge Amount | 19413 |
| Total Medicare Allowed Amount | 10386.48 |
| Total Medicare Payment Amount | 6635.82 |
| Total Medicare Standardized Payment Amount | 8381.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 12 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 638 |
| Total Drug Medicare AllowedAmount | 362.35 |
| Total Drug Medicare PaymentAmount | 342.5 |
| Total Drug Medicare Standardized Payment Amount | 342.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 173 |
| Number Of Medicare Beneficiaries With Medical Services | 90 |
| Total Medical Submitted Charge Amount | 18775 |
| Total Medical Medicare Allowed Amount | 10024.13 |
| Total Medical Medicare Payment Amount | 6293.32 |
| Total Medical Medicare Standardized Payment Amount | 8039.03 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | 25 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 55 |
| Number Of Male Beneficiaries | 35 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1253 |