| National Provider Identifier [NPI]: | 1093710345 |
| Last Name Of The Provider | GELLER |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18370 BURBANK BLVD |
| Street Address 2 Of The Provider | STE 601 |
| City Of The Provider | TARZANA |
| Zip Code Of The Provider | 913562831 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 14603 |
| Number Of Medicare Beneficiaries | 596 |
| Total Submitted Charge Amount | 689037 |
| Total Medicare Allowed Amount | 342978.91 |
| Total Medicare Payment Amount | 284221.64 |
| Total Medicare Standardized Payment Amount | 280499.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 106 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 3660 |
| Total Drug Medicare AllowedAmount | 2214.12 |
| Total Drug Medicare PaymentAmount | 2166.94 |
| Total Drug Medicare Standardized Payment Amount | 2166.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 14497 |
| Number Of Medicare Beneficiaries With Medical Services | 596 |
| Total Medical Submitted Charge Amount | 685377 |
| Total Medical Medicare Allowed Amount | 340764.79 |
| Total Medical Medicare Payment Amount | 282054.7 |
| Total Medical Medicare Standardized Payment Amount | 278332.84 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 249 |
| Number Of Beneficiaries Age 75 to 84 | 194 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 357 |
| Number Of Male Beneficiaries | 239 |
| Number Of Non Hispanic White Beneficiaries | 546 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 555 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 41 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3601 |