| National Provider Identifier [NPI]: | 1912947854 |
| Last Name Of The Provider | MENDELLA |
| First Name Of The Provider | LOUIS |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1004 HEALTH CENTER DR |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MATTOON |
| Zip Code Of The Provider | 619389253 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 4049 |
| Number Of Medicare Beneficiaries | 608 |
| Total Submitted Charge Amount | 1331433.2 |
| Total Medicare Allowed Amount | 391613.81 |
| Total Medicare Payment Amount | 296971.39 |
| Total Medicare Standardized Payment Amount | 300611.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 719 |
| Number Of Medicare Beneficiaries With Drug Services | 333 |
| Total Drug Submitted ChargeAmount | 33315 |
| Total Drug Medicare AllowedAmount | 7498.7 |
| Total Drug Medicare PaymentAmount | 5619.06 |
| Total Drug Medicare Standardized Payment Amount | 5619.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 148 |
| Number Of Medical Services | 3330 |
| Number Of Medicare Beneficiaries With Medical Services | 608 |
| Total Medical Submitted Charge Amount | 1298118.2 |
| Total Medical Medicare Allowed Amount | 384115.11 |
| Total Medical Medicare Payment Amount | 291352.33 |
| Total Medical Medicare Standardized Payment Amount | 294992 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 120 |
| Number Of Beneficiaries Age 65 to 74 | 246 |
| Number Of Beneficiaries Age 75 to 84 | 168 |
| Number Of Beneficiaries Age Greater 84 | 74 |
| Number Of Female Beneficiaries | 393 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | 592 |
| 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 | 442 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 166 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1841 |