| National Provider Identifier [NPI]: | 1821255589 |
| Last Name Of The Provider | MOGELOF |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5 BREEZY KNLS |
| Street Address 2 Of The Provider | |
| City Of The Provider | WESTPORT |
| Zip Code Of The Provider | 068801201 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 363 |
| Number Of Medicare Beneficiaries | 204 |
| Total Submitted Charge Amount | 109127 |
| Total Medicare Allowed Amount | 31464.96 |
| Total Medicare Payment Amount | 22333.15 |
| Total Medicare Standardized Payment Amount | 21225 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 1060 |
| Total Drug Medicare AllowedAmount | 317.65 |
| Total Drug Medicare PaymentAmount | 266.03 |
| Total Drug Medicare Standardized Payment Amount | 266.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 336 |
| Number Of Medicare Beneficiaries With Medical Services | 204 |
| Total Medical Submitted Charge Amount | 108067 |
| Total Medical Medicare Allowed Amount | 31147.31 |
| Total Medical Medicare Payment Amount | 22067.12 |
| Total Medical Medicare Standardized Payment Amount | 20958.97 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 12 |
| Number Of Beneficiaries Age 65 to 74 | 94 |
| Number Of Beneficiaries Age 75 to 84 | 62 |
| Number Of Beneficiaries Age Greater 84 | 36 |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 73 |
| Number Of Non Hispanic White Beneficiaries | 193 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 191 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9284 |