| National Provider Identifier [NPI]: | 1669493375 |
| Last Name Of The Provider | GELLMAN |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22411 HAWTHORNE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905052507 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 534 |
| Number Of Medicare Beneficiaries | 325 |
| Total Submitted Charge Amount | 80208 |
| Total Medicare Allowed Amount | 51264.96 |
| Total Medicare Payment Amount | 35559.65 |
| Total Medicare Standardized Payment Amount | 33242.13 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 1484 |
| Total Drug Medicare AllowedAmount | 471.58 |
| Total Drug Medicare PaymentAmount | 352.1 |
| Total Drug Medicare Standardized Payment Amount | 352.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 434 |
| Number Of Medicare Beneficiaries With Medical Services | 325 |
| Total Medical Submitted Charge Amount | 78724 |
| Total Medical Medicare Allowed Amount | 50793.38 |
| Total Medical Medicare Payment Amount | 35207.55 |
| Total Medical Medicare Standardized Payment Amount | 32890.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 134 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 197 |
| Number Of Male Beneficiaries | 128 |
| Number Of Non Hispanic White Beneficiaries | 236 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 287 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 38 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.352 |