| National Provider Identifier [NPI]: | 1255608162 |
| Last Name Of The Provider | MENARD |
| First Name Of The Provider | GUERLINE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 143 LONGWATER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORWELL |
| Zip Code Of The Provider | 020611683 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 350 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 49243 |
| Total Medicare Allowed Amount | 15250.09 |
| Total Medicare Payment Amount | 12118.49 |
| Total Medicare Standardized Payment Amount | 13744.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 21 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 857 |
| Total Drug Medicare AllowedAmount | 402.31 |
| Total Drug Medicare PaymentAmount | 393.33 |
| Total Drug Medicare Standardized Payment Amount | 393.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 329 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 48386 |
| Total Medical Medicare Allowed Amount | 14847.78 |
| Total Medical Medicare Payment Amount | 11725.16 |
| Total Medical Medicare Standardized Payment Amount | 13350.81 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 94 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0922 |