| National Provider Identifier [NPI]: | 1770781650 |
| Last Name Of The Provider | MANDRELL |
| First Name Of The Provider | JOSHUA |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1200 S FARMERVILLE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | RUSTON |
| Zip Code Of The Provider | 712705941 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 8222 |
| Number Of Medicare Beneficiaries | 1431 |
| Total Submitted Charge Amount | 1413529.6 |
| Total Medicare Allowed Amount | 637346.43 |
| Total Medicare Payment Amount | 467898.06 |
| Total Medicare Standardized Payment Amount | 495494.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 383 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 34722.6 |
| Total Drug Medicare AllowedAmount | 33054.55 |
| Total Drug Medicare PaymentAmount | 25845.74 |
| Total Drug Medicare Standardized Payment Amount | 25845.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 92 |
| Number Of Medical Services | 7839 |
| Number Of Medicare Beneficiaries With Medical Services | 1431 |
| Total Medical Submitted Charge Amount | 1378807 |
| Total Medical Medicare Allowed Amount | 604291.88 |
| Total Medical Medicare Payment Amount | 442052.32 |
| Total Medical Medicare Standardized Payment Amount | 469648.56 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 577 |
| Number Of Beneficiaries Age 75 to 84 | 529 |
| Number Of Beneficiaries Age Greater 84 | 237 |
| Number Of Female Beneficiaries | 777 |
| Number Of Male Beneficiaries | 654 |
| Number Of Non Hispanic White Beneficiaries | 1290 |
| Number Of Black or African American Beneficiaries | 123 |
| 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 | 1225 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 206 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0386 |